WO2014143125A1 - Utilisation de composés d'indole pour la réduction des graisses et le resserrement de la peau et des tissus mous - Google Patents

Utilisation de composés d'indole pour la réduction des graisses et le resserrement de la peau et des tissus mous Download PDF

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WO2014143125A1
WO2014143125A1 PCT/US2013/048368 US2013048368W WO2014143125A1 WO 2014143125 A1 WO2014143125 A1 WO 2014143125A1 US 2013048368 W US2013048368 W US 2013048368W WO 2014143125 A1 WO2014143125 A1 WO 2014143125A1
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formula
cooh
alkyl
compound
hydrogen
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PCT/US2013/048368
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English (en)
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Diane Duncan
Tim Kamerzell
Mark A. Palmer
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Alevere Medical Corporation
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Priority to US14/772,602 priority Critical patent/US20160030389A1/en
Priority to AU2013381790A priority patent/AU2013381790A1/en
Priority to EP13878099.4A priority patent/EP2968272B1/fr
Publication of WO2014143125A1 publication Critical patent/WO2014143125A1/fr
Priority to US15/807,081 priority patent/US10258605B2/en
Priority to US16/283,985 priority patent/US10653670B2/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404—Indoles, e.g. pindolol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404—Indoles, e.g. pindolol
    • A61K31/4045—Indole-alkylamines; Amides thereof, e.g. serotonin, melatonin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404—Indoles, e.g. pindolol
    • A61K31/405—Indole-alkanecarboxylic acids; Derivatives thereof, e.g. tryptophan, indomethacin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4164—1,3-Diazoles
    • A61K31/4184—1,3-Diazoles condensed with carbocyclic rings, e.g. benzimidazoles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/4353—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems
    • A61K31/437—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems the heterocyclic ring system containing a five-membered ring having nitrogen as a ring hetero atom, e.g. indolizine, beta-carboline
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/04—Anorexiants; Antiobesity agents

Definitions

  • the present invention relates to indole compounds, compositions, and uses thereof, including uses of the indole compounds and compositions for the reduction or removal of localized fat deposits and/or tightening of skin and soft tissue laxity in subjects.
  • the indole compounds can be employed, for example, in the cosmetic sector or for producing pharmaceutical products.
  • Liposuction is one of the most popular cosmetic surgery procedures currently available. It involves the surgical removal of fat deposits using suction, optionally assisted by solutions to assist in fat removal.
  • Liposuction also known as lipoplasty or suction lipectomy, reduces fat through an incision in the skin through which a cannula is inserted. Tumescent fluid is injected into the treatment region, then the cannula is inserted. The cannula is connected to a suction source and the unwanted fat is aspirated through the cannula and discarded. Liposuction is performed under general or local anesthesia, depending on the amount and location of the fat to be reduced.
  • liposuction and/or other surgical methods of fat removal are associated with significant adverse events including temporary bruising, swelling, numbness or hypersensitivity, soreness and burning sensation, risk of infection, and pigmentation changes.
  • Other more serious complications include the formation of fat clots or blood clots, which can migrate to the lungs and cause death; excessive fluid loss, which can lead to shock; fluid accumulation that must be drained; fluid overload leading to congestive heart failure; friction burns or other damage to the skin or nerves; and perforation injury to the vital organs.
  • liposuction requires a recovery time of up to 1-2 weeks.
  • PC phosphatidylcholine
  • PC is often an ingredient in injectable fat reducing formulas. When isolated, it is produced as a powder. When reconstituted, it is quite viscous and must be mixed with a detergent, such as sodium deoxycholate (hereinafter “DC"), to solubilize it sufficiently to create an injectable form.
  • DC is a bile salt that can function to make the PC soluble in water or other biocompatible solvents; otherwise, the PC can precipitate out of solution.
  • DC has been described as having a "detergent” effect on fat dissolution in a porcine in vitro study and has nonspecific effects on both adipose and muscle cells.
  • Other pharmaceuticals such as FUNGIZONE® (Bristol Myers Squibb, New York, N.Y.) (an injectable form of
  • amphotericin B are commonly combined with bile salts to enhance their solubility and make them compatible with intravenous delivery.
  • the present invention relates to indole compounds, compositions, and uses thereof, including uses of the indole compounds and compositions for the reduction or removal of localized fat deposits and/or tightening of skin and soft tissue laxity in subjects.
  • the present disclosure provides, in some embodiments, a method for nonsurgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (I):
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci ⁇ alkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OCi_6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOC 1-6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R 2 and R 3 together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • the present disclosure provides, in some embodiments, a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising a compound of Formula (I):
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C ⁇ aUcyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OCi-6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOCi_6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R 2 and R 3 together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • the present disclosure provides, in some embodiments, a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (I):
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci-ealkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OC 1 -6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOC 1-6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R 2 and R 3 together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • the present disclosure provides, in some embodiments, a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (I):
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci ⁇ alkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OCi_6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOC 1-6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R 2 and R 3 together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • the present disclosure provides, in some embodiments, a method for preventing or reducing a skin condition (including method of tightening skin and/or lax subcutaneous tissue) associated with aging in a subject comprising locally administering to the subject a composition comprising a compound of Formula (I):
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci ⁇ alkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OCi_6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R and R together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • the present disclosure provides, in some embodiments, a method for treating sleep apnea in a subject comprising locally administering a composition comprising a compound of Formula (I), wherein the sleep apnea is caused by a fat deposit around a trachea in the subject and the administration of the composition is to the fat deposit around the trachea, and wherein Formula (I) is:
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci- 6 alkyl, Ci- 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OCi_ 6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R and R together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • the compound is of Formula (II):
  • R 1 is hydrogen, C 1-6 alkyl, or hydroxy
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C ⁇ aUcyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, -(CH 2 ) x -C(0)-OC 1 _6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X - CN, -OCH 2 C 6 H 5 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COOC 1-6 alkyl, -(CH 2 ) y -CO-COOH, and - (CH 2 ) y -C(H)(OH)-COOH; or
  • x is a number from zero to six
  • y is a number from zero to six
  • the compound is of Formula (III):
  • R 1 is hydrogen, Ci_6 alkyl, or hydroxy
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci ⁇ alkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, -(CH 2 ) x -C(0)-OC 1 _6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X - CN, -OCH 2 C 6 H 5 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and - (CH 2 ) y -C(H)(OH)-COOH; or
  • x is a number from zero to six
  • y is a number from zero to six
  • the compound is of Formula (IV):
  • R 1 is hydrogen, C 1-6 alkyl, or hydroxy
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C 1-6 alkyl, Ci- 6 alkoxy, amino, substituted amino, halogen, -(CH 2 ) x -C(0)-OC 1 _6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X - CN, -OCH 2 C 6 H 5 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and - (CH 2 ) y -C(H)(OH)-COOH; or
  • x is a number from zero to six
  • y is a number from zero to six
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is-CHO or -(CH 2 ) x -COOH.
  • the compound is of Formula (V):
  • R 1 is hydrogen or C 1-6 alkyl
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C 1-6 alkyl, Ci- 6 alkoxy, -OCH 2 C 6 H 5 , halogen, -CHO, -(CH 2 ) x -COOH; and
  • x is a number from zero to six
  • the compound is of Formula (VI):
  • R 1 is hydrogen or C 1-6 alkyl
  • R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C 1-6 alkyl, Ci- 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)-OC 1 _ 6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, -(CH 2 ) X - COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH;
  • R 8 , R 10 , and R 11 are independently selected from hydrogen, halogen, -(CH 2 ) x -C(0)- OC 1 - 6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, -(CH 2 ) y -C(H)(OH)-COOH, phenyl, and substituted phenyl; wherein the substituted phenyl is substituted with 1-4 substituents selected from hydroxyl, Ci- 6 alkoxy, and Ci- 6 alkyl;
  • R 9 is hydrogen or Ci_ 6 alkyl
  • x is a number from zero to six
  • y is a number from zero to six
  • the compound is selected from Compounds 2, 10, 29, 38, 40, 41, 43, and 44. In some embodiments, the compound is Compound 2. In some embodiments, the compound is Compound 43.
  • the administering step is by injection, transdermal pump, transdermal patch, or a subdermal depot. In some embodiments, the administering step is by subcutaneous injection. In some embodiments, the subject is a mammal. In some embodiments, the subject is a human. In some embodiments, the method further comprises administering to the subject a second therapeutic agent.
  • the compound of Formula (I) is a compound selected from those species described or exemplified in the detailed description below.
  • the present disclosure provides a composition comprising a compound of Formula (I) or a pharmaceutically acceptable salt, solvate, or hydrate thereof.
  • the compositions may further comprise a pharmaceutically acceptable excipient (such as pharmaceutically acceptable excipients suitable for injection).
  • the present disclosure also provides a composition comprising a compound of Formula (I) or a pharmaceutically acceptable salt thereof for use as a medicament.
  • the present disclosure also provides a composition comprising a compound of Formula (I) or a pharmaceutically acceptable salt thereof and a pharmaceutically acceptable excipient, wherein the composition is suitable for local administration, such as injection (such as subcutaneous injection, intradermal injection, or intramuscular injection), transdermal pump, transdermal patch, or subdermal depot.
  • injection such as subcutaneous injection, intradermal injection, or intramuscular injection
  • transdermal pump such as transdermal pump, transdermal patch, or subdermal depot.
  • the present disclosure provides a composition comprising a compound of Formula (I) or a pharmaceutically acceptable salt thereof for use in therapy.
  • the present disclosure provides, in some embodiments, a composition comprising a compound of Formula (I) for non-surgical reduction or removal of one or more localized fat deposits in a subject.
  • the present disclosure provides, in some embodiments, a composition comprising a compound of Formula (I) for reducing a subcutaneous fat deposit in a subject.
  • the present disclosure provides, in some embodiments, a composition comprising a compound of Formula (I) for treating an adipose tissue disorder or an adipose tissue tumor in a subject.
  • the present disclosure provides in some embodiments, a composition comprising a compound of Formula (I) for preventing or reducing a skin condition (including method of tightening skin and lax subcutaneous tissue) associated with aging in a subject.
  • a composition comprising a compound of Formula (I) for the treatment or improvement of skin and soft tissue laxity due to aging, weight loss, genetic determinants or other disorder.
  • a composition comprising a compound of Formula (I) for treating sleep apnea in a subject.
  • the present disclosure provides, in some embodiments, a composition comprising a compound of Formula (I) for the manufacture of a medicament for non- surgical reduction or removal of one or more localized fat deposits in a subject.
  • a composition comprising a compound of Formula (I) for the manufacture of a medicament for reducing a subcutaneous fat deposit in a subject.
  • a composition comprising a compound of Formula (I) for the manufacture of a medicament for treating an adipose tissue disorder or an adipose tissue tumor in a subject.
  • the present disclosure provides, in some embodiments, a composition comprising a compound of Formula (I) for the manufacture of a medicament for decreasing submental fat deposit under a skin area in a subject.
  • a composition comprising a compound of Formula (I) for the manufacture of a medicament for preventing or reducing a skin condition
  • the present disclosure provides, in some embodiments, a composition comprising a compound of Formula (I) for the manufacture of a medicament for the treatment or improvement of skin and soft tissue laxity due to aging, weight loss, genetic determinants or other disorder.
  • a composition comprising a compound of Formula (I) for the manufacture of a medicament for treating sleep apnea in a subject.
  • the present disclosure provides a kit for the reduction or removal of localized fat deposits and/or skin and soft tissue tightening in a subject.
  • the present disclosure provides a kit comprising a container, wherein the container comprises a composition comprising a compound of Formula (I).
  • the present disclosure provides a syringe comprising a composition comprising a compound of Formula (I).
  • the present disclosure provides a unit dose comprising an amount of a composition comprising a compound of Formula (I).
  • Figure 1 Change in Ethidium Bromide Fluorescence (EB) Intensity as a function of incubation time. Approximately 1.5-2 million adipocyte cells/ml were incubated for varying amounts of time in the presence of test compounds. (B) Magnified portion of Figure 1A highlighting the diverse range of activity.
  • EB Ethidium Bromide Fluorescence
  • FIG. 1 Histogram profiles of Ethidium Bromide Fluorescence Intensity and signal ratio at (A-B) 1 hour (C-D) 4 hours (E-F) 18 hours and (G-H) 24 hours after incubation of adipocytes with test compounds.
  • the signal ratio is a normalized measure of cell death that incorporates live cell quantity.
  • Figure 3 Concentration dependent effects of test compounds on adipocyte cell cytotoxicity (EB signal) after incubation for (A) 1 hour (B) 12 hours and (C) 24 hours.
  • Figure 4. Histogram profiles of Ethidium Bromide Fluorescence Intensity and signal ratio after incubation of adipocytes with 10 mg/ml drug substance for (A-B) 1 hour (C- D) 12 hours and (E-F) 24 hours.
  • Figure 8 LIVE/DEAD® assay results for test compounds for adipocytes, dermis, and muscle cells for Compound F (saline control), Compounds G (Aqualyx ®), and Compounds 41, 43, and 44. All the bars in Figure 8 indicate kill rate (ethidium).
  • kill rate ethidium
  • “a” refers to compound tissue preference at 2 hours.
  • “b” refers to compound tissue preference at 5 hours.
  • Figure 9A shows a saline control with adipocytes intact.
  • Figure 9B shows a histology test sample with 1% deoxycholate at 4 hours.
  • Figure 9C shows a histology test sample with PC50/ DC 24 at 12 hours.
  • Figure 9D shows a histology test sample with Compound 88 at 4 hours.
  • Figure 9E shows a histology test sample with Compound 41 at twelve hours.
  • Figure 9F shows a histology test sample with Compound 38 at four hours.
  • Figure 9G shows a histology test sample with Compound 2 at 1 hour.
  • Figure 9H shows a histology test sample with Compound 29 at 12 hours.
  • Figure 91 shows a histology test sample with Compound 33 at 4 hours.
  • Figure 10 shows a diagram of an injection pattern for basic level users of an injectable lipolytic composition.
  • Figure 11 shows the kill rate of adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells treated with saline, excipient, phosphatidylcholine plus deoxycholate, or Aqualyx.
  • Figure 12 shows the kill rate of adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells treated with test compounds A-E compared to Aqualyx, phosphatidylcholine plus deoxycholate, and saline controls.
  • Figure 13 shows the kill rate of adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells treated with test compounds F-J compared to Aqualyx,
  • Figure 14 shows the effect of a sample compound on a mouse fat pad graft one day after injection.
  • Figure 15 shows the effect of Compound B on a mouse fat pad graft one week after injection.
  • Figure 16 shows the effect of deoxycholate on a mouse fat pad graft one day after injection.
  • Figure 17 shows the effect of Compound D (above) compared to excipient control (below) on a mouse fat pad graft one week after injection.
  • Figure 18 shows the effect of Compound H on a mouse fat pad graft one week after injection.
  • Figure 19 shows the effect of Compound I on a mouse fat pad graft two weeks after injection.
  • Figure 20 shows the effect of Compound I on a fat pad graft four weeks after injection.
  • Figure 21 shows the effect of phosphatidylcholine plus deoxycholate on a mouse fat pad graft four weeks after injection.
  • Figure 22 shows a scanning electron micrograph of the effect of saline control on fat cells.
  • Figure 23 shows a scanning electron micrograph of the effect of deoxycholate on fat cells.
  • Figure 24 shows a scanning electron micrograph of an untreated, cultured adipocyte.
  • Figure 25 shows a scanning electron micrograph of an intact adipocyte in vivo.
  • Figure 26 shows a scanning electron micrograph of cultured adipocytes treated with phosphatidylcholine plus deoxycholate four hours after treatment.
  • Figure 27 shows a scanning electron micrograph of adipocytes treated in vivo with phosphatidylcholine plus deoxycholate four weeks after treatment.
  • Figure 28 shows a scanning electron micrograph of a single cultured adipocyte treated with deoxycholate after four hours of treatment.
  • Figure 29 shows a scanning electron micrograph of tissue treated with deoxycholate four weeks after treatment.
  • Figure 30 shows a mechanism of action for adipocyte cell death.
  • Figure 31 shows a mechanism of action for adipocyte cell death.
  • Figure 32 shows a scanning electron micrograph of adipocytes treated with Compound A in vivo four weeks after treatment.
  • Figure 33 shows a scanning electron micrograph of the effect of Compound B on a cultured adipocyte.
  • Figure 34 shows a scanning electron micrograph of adipocytes treated with Compound B in vivo four weeks after treatment.
  • Figure 35 shows a scanning electron micrograph of adipocytes treated with Compound C in vivo after four hours of treatment.
  • Figure 36 shows a scanning electron micrograph of adipocytes treated with DMSO excipient in vivo four weeks after treatment.
  • Figure 37 shows a scanning electron micrograph of an adipocyte undergoing poration.
  • Figure 38 shows a scanning electron micrograph of an adipocyte with lipid droplets underneath its cell membrane.
  • Figure 39 shows a scanning electron micrograph of an adipocyte undergoing effusion.
  • Figure 40 shows a scanning electron micrograph of an adipocyte treated with Compound J four weeks after treatment.
  • Figure 41 shows a scanning electron micrograph of an adipocyte undergoing cell death.
  • Figure 42 shows a scanning electron micrograph of adipocytes treated with saline in vivo four weeks after treatment.
  • Figure 43 shows a scanning electron micrograph of adipocytes treated with phosphatidyl choline and deoxycholate in vivo four weeks after treatment.
  • Figure 44 shows a scanning electron micrograph of adipocytes treated with deoxycholate in vivo four weeks after treatment.
  • Figure 45 shows a scanning electron micrograph of adipocytes treated with Compound J four weeks after treatment.
  • Figure 46 shows a scanning electron micrograph of human fat treated with Compound D four weeks after treatment.
  • Figure 47 shows a scanning electron micrograph of adipocytes treated with Compound E in vivo, four weeks after treatment.
  • Figure 48 shows a scanning electron micrograph of adipocytes treated with Compound I in vivo, four weeks after treatment.
  • Figure 49 shows a scanning electron micrograph of adipocytes treated with Compound H four weeks after treatment.
  • Figure 50 shows a scanning electron micrograph of adipocytes treated with Compound I four hours after treatment.
  • Alkyl refers to monovalent saturated aliphatic hydrocarbyl groups having from 1 to 10 carbon atoms and preferably 1 to 6 carbon atoms. This term includes, by way of example, linear and branched hydrocarbyl groups such as methyl (CH 3 -), ethyl (CH 3 CH 2 -), n- propyl (CH 3 CH 2 CH 2 -), isopropyl ((CH 3 ) 2 CH-), n-butyl (CH 3 CH 2 CH 2 CH 2 -), isobutyl ((CH 3 ) 2 CHCH 2 -), sec-butyl ((CH 3 )(CH 3 CH 2 )CH-), t-butyl ((CH 3 ) 3 C-), n-pentyl
  • Alkoxy refers to the group -O-alkyl, wherein alkyl is as defined herein. Alkoxy includes, by way of example, methoxy, ethoxy, n-propoxy, isopropoxy, n-butoxy, t- butoxy, sec-butoxy, n-pentoxy, and the like.
  • alkoxy also refers to the groups alkenyl-O-, cycloalkyl-O-, cycloalkenyl-O-, and alkynyl-O-, where alkenyl, cycloalkyl, cycloalkenyl, and alkynyl are as defined herein.
  • Amino refers to the group -NH 2 .
  • Substituted amino refers to the group -NRR where each R is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, cycloalkenyl, substituted cycloalkenyl, alkynyl, substituted alkynyl, aryl, heteroaryl, and heterocyclyl provided that at least one R is not hydrogen.
  • Carbaldehyde and “carboxaldehyde” refer to the group -CHO.
  • Halogen refers to fluoro, chloro, bromo, and iodo.
  • carbocyclic ring refers to fluoro, chloro, bromo, and iodo.
  • carbocyclic ring refers to a ring or ring system wherein the atoms forming the ring backbone are selected only from carbon. Unless otherwise indicated, a carbocyclic ring can be a saturated, partially unsaturated, or fully unsaturated ring. When a fully unsaturated carbocyclic ring satisfies Huckel's rule, then the ring is also called an "aromatic ring".
  • saturated carbocyclic refers to a ring having a backbone consisting of carbon atoms linked to one another by single bonds; unless otherwise specified, the remaining carbon valences are occupied by hydrogen atoms.
  • Heteroaryl refers to an aromatic group of from 1 to 15 carbon atoms, such as from 1 to 10 carbon atoms and 1 to 10 heteroatoms selected from the group consisting of oxygen, nitrogen, and sulfur within the ring.
  • Such heteroaryl groups can have a single ring (such as, pyridinyl, imidazolyl or furyl) or multiple condensed rings in a ring system (for example as in groups such as, indolizinyl, quinolinyl, benzofuran, benzimidazolyl or benzothienyl), wherein at least one ring within the ring system is aromatic and at least one ring within the ring system is aromatic, provided that the point of attachment is through an atom of an aromatic ring.
  • the nitrogen and/or sulfur ring atom(s) of the heteroaryl group are optionally oxidized to provide for the N-oxide (N ⁇ 0), sulfinyl, or sulfonyl moieties.
  • This term includes, by way of example, benzimidazolyl, pyridinyl, pyrrolyl, indolyl, thiophenyl, and furanyl.
  • heteroaryl groups can be optionally substituted with 1 to 5 substituents, or from 1 to 3 substituents, selected from acyloxy, hydroxy, thiol, acyl, alkyl, alkoxy, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, substituted alkyl, substituted alkoxy, substituted alkenyl, substituted alkynyl, substituted cycloalkyl, substituted cycloalkenyl, amino, substituted amino, aminoacyl, acylamino, alkaryl, aryl, aryloxy, azido, carboxyl, carboxyl ester, cyano, halogen, nitro, heteroaryl, heteroaryloxy, heterocyclyl, heterocyclooxy, aminoacyloxy, oxyacylamino, thioalkoxy, substituted thioalkoxy, thioaryloxy,
  • heteroaryls include, but are not limited to, benzimidazole, pyrrole, imidazole, pyrazole, pyridine, pyrazine, pyrimidine, pyridazine, indolizine, isoindole, indole, purine, isoquinoline, quinoline, phthalazine, naphthylpyridine, quinoxaline, quinazoline, cinnoline, pteridine, carbazole, carboline, phenanthridine, acridine,
  • phenanthroline isothiazole, phenazine, isoxazole, phenoxazine, phenothiazine, piperidine, piperazine, phthalimide, 4,5,6,7-tetrahydrobenzo[b]thiophene, thiazole, thiophene, benzo[b]thiophene, and the like.
  • Heterocycle refers to a saturated or partially unsaturated group having a single ring or multiple condensed rings, including fused, bridged, or spiro ring systems, and having from 3 to 20 ring atoms, including 1 to 10 hetero atoms.
  • These ring atoms are selected from the group consisting of carbon, nitrogen, sulfur, or oxygen, wherein, in fused ring systems, one or more of the rings can be cycloalkyl, aryl, or heteroaryl, provided that the point of attachment is through the non- aromatic ring.
  • the nitrogen and/or sulfur atom(s) of the heterocyclic group are optionally oxidized to provide for N-oxide, -S(O)-, or -S0 2 - moieties.
  • heterocycles include, but are not limited to, azetidine, dihydroindole, indazole, quinolizine, imidazolidine, imidazoline, piperidine, piperazine, indoline, 1,2,3,4-tetrahydroisoquinoline, thiazolidine, morpholinyl, thiomorpholinyl (also referred to as thiamorpholinyl), 1,1-dioxothiomorpholinyl, piperidinyl, pyrrolidine, tetrahydrofuranyl, and the like.
  • heteroaryl or heterocyclyl group is "substituted," unless otherwise constrained by the definition for the heteroaryl or heterocyclic substituent, such heteroaryl or heterocyclic groups can be substituted with 1 to 5, or from 1 to 3 substituents, selected from alkyl, substituted alkyl, alkoxy, substituted alkoxy, cycloalkyl, substituted cycloalkyl, cycloalkenyl, substituted cycloalkenyl, acyl, acylamino, acyloxy, amino, substituted amino, aminoacyl, aminoacyloxy, azido, cyano, halogen, hydroxyl, oxo, thioketo, carboxyl, carboxyl ester, thioaryloxy, thioheteroaryloxy, thioheterocyclooxy, thiol, thioalkoxy, substituted thioalkoxy, aryl, aryloxy, heteroaryl, hetero
  • substituted when used to modify a specified group or radical, can mean that one or more hydrogen atoms of the specified group or radical are each,
  • a group that is substituted has 1, 2, 3, or 4 substituents, 1, 2, or 3 substituents, 1 or 2 substituents, or 1 substituent.
  • any of the groups disclosed herein which contain one or more substituents it is understood, of course, that such groups do not contain any substitution or substitution patterns which are sterically impractical and/or synthetically non-feasible.
  • the subject compounds include all stereochemical isomers arising from the substitution of these compounds.
  • salt means a salt which is acceptable for administration to a subject, such as a mammal (salts with counterions having acceptable mammalian safety for a given dosage regime). Such salts can be derived from
  • “Pharmaceutically acceptable salt” refers to pharmaceutically acceptable salts of a compound, which salts are derived from a variety of organic and inorganic counter ions well known in the art and include, by way of example only, sodium, potassium, calcium, magnesium, ammonium, tetraalkylammonium, and the like; and when the molecule contains a basic functionality, salts of organic or inorganic acids, such as hydrochloride, hydrobromide, formate, tartrate, besylate, mesylate, acetate, maleate, oxalate, and the like.
  • salt thereof means a compound formed when a proton of an acid is replaced by a cation, such as a metal cation or an organic cation and the like.
  • the salt is a pharmaceutically acceptable salt, although this is not required for salts of intermediate compounds that are not intended for administration to the subject.
  • salts of the present compounds include those wherein the compound is protonated by an inorganic or organic acid to form a cation, with the conjugate base of the inorganic or organic acid as the anionic component of the salt.
  • solvent refers to a complex formed by combination of solvent molecules with molecules or ions of the solute.
  • the solvent can be an organic compound, an inorganic compound, or a mixture of both.
  • Some examples of solvents include, but are not limited to, methanol, N,N-dimethylformamide, tetrahydrofuran, dimethylsulfoxide, and water. When the solvent is water, the solvate formed is a hydrate.
  • pyrazoles imidazoles, benzimidazoles, triazoles, and tetrazoles.
  • an "effective dosage” or “effective amount” of drug, compound, or pharmaceutical composition is an amount sufficient to effect beneficial or desired results.
  • An effective dosage can be administered in one or more administrations.
  • an effective dosage of a drug, compound, or pharmaceutical composition is an effective dosage of a drug, compound, or pharmaceutical composition.
  • composition may or may not be achieved in conjunction with another drug, compound, or pharmaceutical composition.
  • an "effective dosage" may be considered in the context of administering one or more therapeutic agents, and a single agent may be considered to be given in an effective amount if, in conjunction with one or more other agents, a desirable result may be or is achieved.
  • in conjunction with refers to administration of one treatment modality in addition to another treatment modality.
  • in conjunction with refers to administration of one treatment modality before, during or after administration of the other treatment modality to the individual.
  • An "individual” or a “subject” is a mammal, more preferably a human.
  • Mammals also include, but are not limited to, farm animals, sport animals, pets (such as cats, dogs, horses), primates, mice and rats.
  • Reference to "about” a value or parameter herein includes (and describes) embodiments that are directed to that value or parameter per se. For example, description referring to "about X” includes description of "X.”
  • the present invention provides methods and lypolytic indole compounds for reducing fat and/or tightening skin and lax soft tissue.
  • Tissue specificity is an important consideration for developing lipolytic agents.
  • Compounds that are not tissue-specific may have significant effect on neighboring tissues, for example necrosis of blood vessels, eccrine, glands, the reticular layer of the dermis, and demyelination of peripheral nerves, leading to side effects such as skin loss, itching, numbness, paresthesia, or even mandibular nerve palsy.
  • indole-based compounds are effective in killing adipocytes selectively and while in the meantime less toxic to muscle cells, nerve cells, and dermal cells. These compounds are therefore particularly suitable for fat reduction in vivo.
  • these indole compounds may have specific functional profiles in terms of potency, cell specificity, and cell killing characteristics (for example apoptotic, cytolytic, and/or pyroptotic), and that such functional profiles make them particularly suitable for fat reduction, skin and soft tissue tightening, and/or other applications discussed herein.
  • a tailored treatment can therefore be developed depending on the amount of fat to be removed, the amount of anticipated post-treatment tissue laxity or firmness, as well as the effect on the skin surface area.
  • the indole compounds are apoptotic and non-inflammatory. It was previously shown that injection of currently available lipolysis drugs, such as deoxycholate or phosphatidylcholine combined with deoxycholate, produce significant side effects such as prominent and immediate swelling, bruising, pain, and inflammation. Fat-reducing injections that cause little or no swelling, bruising, or pain would therefore be particularly advantageous in many instances and would allow patients undergo more than one treatments in the desired region without severe sequelae. Examples of such desirable treatment regions include, for example, abdomen, thighs, flanks, and any other regions with significant adiposity.
  • the indole compounds are cytolytic and inflammatory.
  • the cytolytic effect i.e., cell membrane rupture in soft tissue is most likely to cause significant inflammation. While this mechanism may lead to swelling and possibly bruising, the inflammation may lead to soft tissue tightening, skin surface area reduction, and the production of tissue firmness in the case of previous laxity. This is particularly useful when removing fat in areas involving skin laxity. For example, the degree of pendulous overhang of a region (such as a jowl or a "bat wing" of the arm) can be improved. An area which previously drooped below a normal axis can be lifted, with restoration of a normal contour.
  • the indole compounds are pyroptotic, i.e., having a combined effect of apoptosis and cytolysis. Such compounds are particularly useful when both fat reduction and improvement and skin laxity are desirable.
  • the present invention in one aspect provides compositions suitable for reducing or removing localized fat deposits and/or tightening skin.
  • methods for reducing or removing localized fat deposit and/or tightening skin are also provided. kits, unit doses, and articles of manufacture useful for methods described herein.
  • the present disclosure provides methods for using an indole compound.
  • the methods include, but are not limited to, a method for non-surgical reduction of one or more localized fat deposits; a method for reducing a subcutaneous fat deposit; a method for treating an adipose tissue disorder or an adipose tissue tumor; a method for decreasing submental fat deposit under a skin area; a method of preventing or reducing a skin condition associated with aging; and a method for treating obstructive sleep apnea.
  • the methods are described in more detail below.
  • the present disclosure provides methods for non-surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising an indole compound (such as a compound of Formula (I)).
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for non-surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (II).
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (III).
  • a method for non-surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (V).
  • a method for non-surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (VI).
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 2.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 10.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 29.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 38.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 40.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 41.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 43.
  • a method for non- surgical reduction or removal of one or more localized fat deposits in a subject having localized fat accumulation comprising administering to a target site in the fat deposit a composition comprising compound 44.
  • the method is not used in conjunction with liposuction, lipoplasty, suction lipectomy, or ultrasonification.
  • the method herein is used in conjunction with liposuction, lipoplasty, or suction lipectonmy, or ultrasonification.
  • the present disclosure also provides a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising an indole compound (such as a compound of Formula (I)).
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising a compound of Formula (II).
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • a composition comprising a compound of Formula (III).
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • a composition comprising a compound of Formula (IV).
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • a composition comprising a compound of Formula (V).
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • a composition comprising a compound of Formula (VI).
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising compound 10.
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising compound 29.
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising compound 38.
  • a method for reducing a subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising administering to a target site in the subcutaneous fat deposit a composition comprising compound 43.
  • subcutaneous fat deposit in a subject having subcutaneous fat deposit comprising
  • compositions comprising compound 44.
  • the methods described herein are useful for one or more of the following: 1) killing fat cells in a localized region; 2) dissolving fat in the localized region; and/or 3) for cosmetic purposes.
  • Adipose tissue (or body fat, or fat deposit, or fat) is loose connective tissue containing adipocytes.
  • Adipose tissue can be found, for example, at the skin (subcutaneous fat), around internal organs (visceral fat), in bone marrow (yellow bone marrow) and in breast tissue.
  • the present methods can be used for reducing fat deposit in any of these adipose tissues.
  • the fat to be reduced or removed can be of varying hardness, depending on its contents.
  • the fat deposit is soft fat.
  • the fat deposit is fibrotic fat. While adipocytes are one component of the fatty layer, there are many different cell types in the hypodermis.
  • adipocytes About 18% of these cells are adipocytes.
  • a fibroseptal network the collagenous framework in which the adipocytes reside. This layer is also known as the stromal vascular fraction. The present methods can be used for reducing the fibroseptal network.
  • compositions and methods can be used to treat any adipose condition in a subject.
  • Adipose conditions include, for example, disorders such as metabolic syndrome, obesity, fat redistribution syndrome, eyelid fat herniation, lipoma, herniation, cellulite, lipodystrophy (including buffalo hump lipodystrophy), dorsocervical fat, visceral adiposity, breast enlargement, hyperadiposity, diffused body fat around trunk and arms, fat deposits associated with cellulite, Dercum's disease, Madelung's neck, lipedema, piezogenic nodules, Launois Cleret syndrome, and xanthelasma.
  • the present disclosure also provides for a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising an indole compound (such as a compound of Formula (I)).
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (II).
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (III).
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (III).
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (V).
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (VI).
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising a compound of Formula (VI).
  • composition comprising compound 2.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising compound 10.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising compound 29.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising compound 38.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising compound 40.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a
  • composition comprising compound 41.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising compound 43.
  • a method for treating an adipose tissue disorder or an adipose tissue tumor in a subject comprising locally administering to the subject a composition comprising compound 44.
  • the method is for cosmetic purposes.
  • Adipose tissue disorders include, for example, disorders such as metabolic syndrome, familial lipomatosis, lipoma, Dercum's disease, Madelung's neck, lipedema, piezogenic nodule, xanthelasma, lipodystrophy, and cellulite.
  • Adipose tissue disorders show, in contrast to the food-related obesity-correlated lipohypertrophy, tissue conditions or identities which can be pathologically differentiated unambiguously and which can be described by histological parameters of scarring and inflammation, but also by connective tissue encapsulations and by changes in the histological adipose tissue morphology itself.
  • a lipoma can be categorized as pathological because they grow and their connective tissue envelope may be painful per se, as well as the compression derived therefrom on blood vessels, which may cause neuralgia.
  • the compositions can be used to treat an adipose condition, adipose tissue disorder, lipodystrophy, or adipose tissue tumor in various areas of a subject.
  • the compositions can be used to reduce or remove fat deposits localized under the eyes, in the lower face and jowls, under chin, under arm, buttock, calf, back, thigh, ankle, stomach, cheek, brow, "love-handles", ankles, lips, or trachea of a subject.
  • the compositions can be used to treat omental adipocyte hypertrophy.
  • areas of laxity with adjacent fat can be treated, such as the vagina, urethra, and uvula, with the compositions.
  • the total volume, unit dose and number of treatments administered may vary depending on the amount of fat in a target site, the location of the target site, type of fat composition, the degree of tissue laxity, and desired results. In general, the greater the amount of fat being treated, the greater the dose that is administered. The type of compound used will depend on the relative degree of fatty hypertrophy versus tissue laxity.
  • the compositions and unit dosages herein may be administered to a subject as part of a treatment regimen or as an individual treatment session.
  • the method further includes a step of ascertaining the effectiveness of the method.
  • the effectiveness is determined by a physical measurement, such as MRI, high resolution ultrasound, or caliper.
  • the localized fat is reduced by at least 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, or 10% of the volume, or by at least 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, or 10% of its thickness, as determined by MRI or by caliper measurement.
  • the % of the volume reduction can be determined by subtracting the volume after treatment (volume after treatment: Vf) and that of the baseline (initial volume or volume before treatment: Vi), divided by Vi and multiplied by 100.
  • the % of the thickness reduction can be determined by subtracting the thickness after treatment (thickness after treatment: Tf) and that of the baseline (initial volume or volume before treatment: Ti), divided by Ti and multiplied by 100.
  • percentage reduction in volume if Vi is 6346.8 cc, Vf is 5376.6 cc, then the volume is reduced by 18%.
  • Tf is 14.1 mm, then the thickness is reduced by 15%.
  • the present disclosure provides for a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising an indole compound (such as a compound of Formula (I)).
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (II).
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (III).
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (IV).
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (V).
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising a compound of Formula (VI).
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 2.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 10.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 29.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 38.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 40.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 41.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 43.
  • a method for decreasing submental fat deposit under a skin area in a subject comprising administering to a target site in the fat deposit a composition comprising compound 44.
  • the methods described herein are useful for one or more of the following: 1) enhancing facial aesthetics through reduction of submental fat; and/or 2) decreasing submental fat deposit under a skin area in a subject, for enhancing the cosmetic appearance of a subject, or for providing a facial cosmetic benefit to a subject.
  • the submental fat deposit treated by the methods of the present disclosure is cosmetically unappealing but is non-pathological and the reduction of it is to improve the appearance of the subject.
  • the result is reduction of the appearance of a double chin.
  • the method is non-surgical and does not include liposuction.
  • the method can further include a step of ascertaining the effectiveness of the method.
  • the effectiveness is determined by a physical measurement, such as MRI, high resolution ultrasound, or caliper.
  • a thickness and/or volume of the submental fat deposit can be measured with magnetic resonance imaging (MRI), high resolution ultrasound, or by a caliper.
  • the thicknesses and/or volumes of the submental fat deposit can be compared before and after the treatment to assess the effectiveness of the treatment.
  • the thickness and/or volume is reduced by at least about 10%, or by at least about 15%, 20%, 25%, 30%, 35%, 40%, 45%, or 50%.
  • the reduction of submental fat can enhance the facial appearance of said subject.
  • the enhanced facial appearance is due to the reduction of prominence of a double chin.
  • the effectiveness of the treatment can be assessed by visual inspection for a reduction of prominence of a double chin or lack of a double chin.
  • the lessening of the double chin appearance may be determined by the improvement in the degree of the submental convexity of the area under the chin.
  • the present disclosure provides for a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising an indole compound (such as a compound of Formula (I)).
  • a composition comprising an indole compound (such as a compound of Formula (I)).
  • the present disclosure also provides for a method for the treatment or improvement of skin and soft tissue laxity due to aging, weight loss, genetic determinants or other disorder.
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising a compound of Formula (II). In some embodiments, there is provided a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising a compound of Formula (III). In some embodiments, there is provided a method for preventing or reducing a skin condition associated with aging in a subject comprising locally
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising a compound of Formula (V).
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising a compound of Formula (VI).
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally
  • a composition comprising compound 2 there is provided a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 10. In some embodiments, there is provided a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 29. In some embodiments, there is provided a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 38. In some embodiments, there is provided a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 40.
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 41.
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 43.
  • a method for preventing or reducing a skin condition associated with aging in a subject comprising locally administering to the subject a composition comprising compound 44.
  • skin conditions associated with aging include loose skin, irregularities of the skin, and wrinkles.
  • the methods described herein are useful for one or more of the following: 1) rejuvenating skin; 2) skin and subcutaneous tissue tightening; 3) causing skin and soft tissue retraction in a body region containing fat deposits, such as localized fat, cellulite, or a postlipoplasty deformity; 4) alleviating skin conditions, including cellulite, rippling, divots (skin contour irregularities following lipoplasty), and protuberances; 5) removing localized excess skin; and/or 6) firming the skin and soft tissue.
  • the compositions are administered locally to a target area to create an inflammatory response causing subcutaneous collagen deposition with subsequent soft tissue retraction.
  • the formation of a scar results in skin and soft tissue tightening especially in areas where the skin is under little or no tension and provides little resistance to fibroseptal contraction.
  • Such treatment may be relevant in a number of clinical scenarios such as, for example, commonly performed fat treatments, including, but not limited to, large volume liposuction. The latter may be associated with post-liposuction, or weight loss induced skin and soft tissue laxity.
  • a composition comprising a therapeutically effective amount of an indole compound may be administered to a liposuction site after completion of the liposuction procedure.
  • the indole compound is a compound of Formula (I).
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for local administration to a target area to create an inflammatory response causing subcutaneous collagen deposition with subsequent soft tissue retraction of compound 40 In some embodiments, there is provided a method for local administration to a target area to create an inflammatory response causing subcutaneous collagen deposition with subsequent soft tissue retraction of compound 41. In some embodiments, there is provided a method for local administration to a target area to create an inflammatory response causing subcutaneous collagen deposition with subsequent soft tissue retraction of compound 43. In some embodiments, there is provided a method for local administration to a target area to create an inflammatory response causing subcutaneous collagen deposition with subsequent soft tissue retraction of compound 44.
  • the target area is an area under eye, under chin, under arm, buttock, calf, back, thigh, stomach, cheek, brow, or any other skin regions showing aging, wrinkles, loose skin or skin irregularity.
  • the method can further include a step of ascertaining the effectiveness of the method.
  • the present disclosure also provides a method for ascertaining the effectiveness of a therapy for preventing or reducing a skin condition associated with aging in a subject, comprising comparing the skin condition of the subject before therapy with the skin condition of the subject after therapy, wherein smooth skin retraction without rippling, crease, or local indentation in the subject after therapy indicates effective therapy. The comparison can be done by visual inspection or patient satisfaction surveys. Other methods of ascertaining the effectiveness of the method include high resolution ultrasound, MRI dermatological wrinkle scale, Canfield Vectra 3D® imaging system, and calipers. High resolution ultrasound can be used to measure the thickness of a fatty deposit at certain sites.
  • MRI is currently the "gold standard” in measuring the depth and width of subcutaneous fat deposits in a given region.
  • Canfield Vectra 3D® imaging system is a mathematical way of determine smoothness of skin. The system uses a quadratic equation to determine positive and negative variations to form a computer-generated ideal of smooth curved surface for a given photographed region. The "smoothness index" is a way to measure the pre-treatment variation from the ideal surface. After treatment, another 3D photo is taken. The treatment region is identified, and the equation can be used to determine the change/improvement in surface contour irregularity.
  • the present disclosure provides for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising an indole compound (such as a compound of Formula (I)).
  • the method comprises administering a compound of any one of Formula (II), (III), (IV), (V) and (VI) or any one of Compounds 2, 10, 29, 38, 40, 41, 43, and 44.
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising a compound of Formula (II).
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising a compound of Formula (III). In some embodiments, there is provided a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising a compound of Formula (IV). In some embodiments, there is provided a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising a compound of Formula (V).
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising a compound of Formula (VI).
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 2.
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 10.
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 29.
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 38. In some embodiments, there is provided a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 40. In some embodiments, there is provided a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 41. In some embodiments, there is provided a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 43.
  • a method for a method for treating obstructive sleep apnea comprising locally administering to the subject a composition comprising compound 44.
  • Obstructive sleep apnea is characterized by repetitive pauses in breathing during sleep due to the obstruction and/or collapse of an upper airway (throat), usually accompanied by a reduction in blood oxygen saturation, and followed by an awakening to breathe. It is a dangerous (sometimes life threatening) condition that often affects obese people. Obese people have a large amount of fat around their trachea, and this fat may cause their airway to collapse when their muscles relax during sleep.
  • the compositions are used to treat obstructive sleep apnea by reducing fat around the trachea.
  • the composition is administered locally (e.g., via injection) to a target site of fat around the trachea in a therapeutically effective amount.
  • the subject being treated is a mammal.
  • a mammal can be a human or an animal such as a primate (e.g., a monkey, chimpanzee, etc.), a domesticated animal (e.g., a dog, cat, horse, etc.), farm animal (e.g., goat, sheep, pig, cattle, etc.), or laboratory animal (e.g., mouse, rat, etc.).
  • a primate e.g., a monkey, chimpanzee, etc.
  • a domesticated animal e.g., a dog, cat, horse, etc.
  • farm animal e.g., goat, sheep, pig, cattle, etc.
  • laboratory animal e.g., mouse, rat, etc.
  • a subject being treated is a human, a horse, a dog, or a cat. In some
  • a subject can be a male or female human.
  • a subject can be a human of any age, such as young age, adolescent age, adult age, middle age, or old age.
  • the subject can be an age of 1-4, 5-9, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, or 90-100 years.
  • a subject is overweight or obese. In some embodiments, a subject is overweight or obese.
  • a subject is of normal weight or underweight. Overweight or obesity can be assessed, for example, by BMI (body mass index).
  • BMI body mass index
  • a method for calculating BMI includes dividing a person's body weight in kilograms by their height in meters squared (weight
  • a BMI of 30 or more is considered obese; a BMI between 25 to 29.9 is considered overweight; a BMI between 18.5 to 24.9 is considered normal weight; a BMI under 18.5 is considered underweight.
  • a subject has a BMI over about 30, such as about 30 to about 50.
  • a subject has a BMI of about 25 to about 29.9. In some embodiments, a subject has a BMI under about 25.
  • the subject has a fat deposit. In some embodiments, the subject has skin and soft tissue laxity. In some embodiments, the subject has a fat deposit and skin and soft tissue laxity.
  • a "target site' used herein refers to an area of the body at which the composition is applied.
  • the target site can be located at the fat deposit and/or the skin area to be affected.
  • the target site can be at different levels of the skin, such as epidermis, dermis, or hypodermis.
  • the target site can be intradermal (within or between layers of skin).
  • the compound is administered locally.
  • Local administration used herein refers to administration of a substance to an area where the action of the substance is desired. Sometimes, administration of the substance is directly to the area where the action of the substance is desired.
  • the compositions are administered via a localized injection. However, other means of administering the compositions are also contemplated. For example, the compositions may be administered via a transdermal pump, a transdermal patch, or a subdermal depot. In some embodiments, the compositions are administered topically.
  • the composition is administered transdermally or subcutaneously, via e.g., a subcutaneous injection using a syringe to a target site.
  • the composition is administered by injection at hypodermis level, injection into the superficial level to mid-layer of subcutaneous fat, mid-layer or deep layer of
  • compositions may be administered at the same, adjacent, or nearby target sites at various intervals, dosages, volumes, as disclosed herein.
  • a target site can be, for example, 0.1 cm x 0.1 cm, to about 5 cm x 5 cm before the procedure.
  • the target site can be 0.1 cm x 0.1 cm, 0.5 cm x 0.5 cm, 1 cm x 1 cm, 2 cm x 2cm, 3 cm x 3cm, 4 cm x 4 cm, or 5 cm x 5 cm.
  • compositions may be administered once or multiple times into the target site.
  • the compositions are administered at least 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 times to a target site. More than one administration can occur in a single week, month, year, 2-5 years, or 5-10 years.
  • the subject is given 1-100, 2-50, 3-30, 4-20, or 5-10 injections at a target site. This number of injections can occur over a period of 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 1 year, 2 years, 3 years, 4 years, 5 years, 6 years, 7 years, 8 years, 9 years, or 10 years.
  • the compositions are administered weekly or 1-8 weeks apart.
  • the subject is given 1 to 10 injections with intervals of 1 to 12 weeks; or 2 to 8 injections with intervals of 2 to 10 weeks; or 2 to 6 injections with intervals of 2 to 8 weeks. In some embodiments, the subject is given 2 to 4 injections with intervals of 4 to 8 weeks.
  • compositions can be administered at various levels below the dermis.
  • the compositions can be administered with a 2-15 mm injection depth.
  • the injection depth is 2-4, 4-6, 6-8, 8-10, 10-12, or 12-15 mm.
  • the injection depth is 4-10, 6-10, 2-8, or 6-8 mm.
  • compositions can be administered anywhere within the fatty layer.
  • compositions are administered with multilevel depots.
  • one administration could be immediately under the skin in the superficial hypodermis; and another administration could be halfway through the hypodermis; and another administration could be deep, just above the fascia.
  • the present disclosure provides a multilevel injection approach, using needles of different lengths.
  • a solution for injection comprises about 1-100 mg/ml of the indole composition. In some embodiments, a solution for injection comprises about 1-5, 6-10, 11-15, or 16-20 mg/ml of the indole composition, n some embodiments, a solution for injection comprises about 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, or 91-100 mg/ml of the indole composition. In some embodiments, a solution for injection comprises about 8-12 or 10 mg/ml of the indole composition.
  • the volume for each injection is about 0.1 ml to about 0.5 ml.
  • the total of an indole compound administered is between about 50 mg to about 100 mg, or from about 60 mg, 70 mg to about 90 mg, 80 mg, without limitation.
  • the method comprises local injection to the target site, through a plurality of injection sites on the skin area, a composition comprising an effective amount of an indole compound, wherein the effective amount is from about 0.01 mg to about 10 mg per injection site.
  • the effective amount is at least about 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mg per injection site.
  • the effective amount if no more than about 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mg per injection site.
  • the plurality of injection sites is substantially evenly distributed on the skin area.
  • substantially evenly refers to injection sites in an area where there are substantially the same number of injection sites per unit of area. In one aspect, a number is substantially the same as another number is they are with about 5% or 10%, or 15% or 20%, or 25% difference.
  • each injection site is from about 0.8 cm to about 1.2 cm distant from an adjacent injection site. In some embodiments, each injection site is from about 0.9 cm to about 1.1 cm distant from an adjacent injection site. In some embodiments, each injection site is about 1 cm distant from an adjacent injection site.
  • the plurality of injection sites comprises at least 20 injection sites, or alternatively at least 25, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 150, 200, 250, 300, 350, 400, 450, or 500 injection sites. In some embodiments, the plurality of injection sites has of no more than about 100, 90, 80, 70, 60, 50, 45, 40, 35, 30, or 25 injection sites. In some embodiments, the plurality of injection sites has from about 40 to about 60 injection sites, or about 50 injection sites.
  • each injection site receives from about 0.1 ml to about 0.5 ml of the composition. In some embodiments, each injection site receives from about 0.1 ml to about 0.25 ml, or alternatively from about 0.26 to about 0.5, or from about 0.2 to about 0.4 ml of the composition.
  • the method utilizes a grid comprising a plurality of injection sites, each of which is from about 0.8 cm to about 1.5 cm distant from an adjacent injection site of the grid; and injecting, with a suitable needle, through each of the plurality of injection sites, into about half way into the target site, an effective amount of a composition comprising from about 0.5% to about 1% (w/w) of an indole compound, wherein each injection constitutes delivery of from about 0.1 ml to about 0.3 ml of the composition.
  • the grid comprises at least 20 injection sites, or at least 25, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, or 100 injection sites. In some embodiments, the grid comprises no more than about 100, 90, 80, 70, 60, 50, 45, 40, 35, 30, or 25 injection sites. In some embodiments, the grid comprises from about 40 to about 60 injection sites, or about 50 injection sites.
  • An alternative pattern would be a multi-level injection, using an under-the- skin type delivery. These would be performed from a single entry site, and would be executed in a ray-type distribution, similar to liposuction. The value of treating multiple levels of adiposity has been recently shown, so a better and more uniform response can be obtained with this method. Also, drugs with poor dispersion can be better delivered to the target tissue this way.
  • the method further comprises pretreating the area around the injection sites with a local anesthetic.
  • anesthetics individually or in combination may be included in the composition such as: ropivacaine, articaine, benzocaine bupivacaine, chloroprocaine, etidocaine, hexylcaine, lontocaine, lidocatine, levobuivaciaine, mepivacaine, prilocaine, procaine, and tetracaine.
  • co-administration of an anesthetic either the composition can reduce the number of injections
  • An indole compound is a compound comprising an indole core.
  • An indole core is shown below:
  • compositions comprising a compound of Formula (I) and compositions comprising a compound of Formula (I).
  • R 1 is hydrogen, C 1-6 alkyl, hydroxyl, or -(CH 2 ) x -CONH 2 ;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C 1-6 alkyl, Ci- 6 alkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)- OCi_6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH; or
  • R 2 and R 3 together with the atoms they attach to, form an unsubstituted or substituted five to seven-membered heterocyclyl ring;
  • x is a number from zero to six
  • y is a number from zero to six
  • R 1 is hydrogen. In some embodiments, R 1 is Ci-6 alkyl. In some embodiments, R 1 is methyl. In some embodiments, R 1 is hydroxy. In some embodiments, R 1 is -(CH 2 ) x -CONH 2 , wherein x is a number from zero to six. In some embodiments, R 1 is -(CH 2 )CONH 2 .
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is selected from halogen, -CHO, and -(CH 2 ) x -COOH.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is a halogen. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo. In some embodiments, R 2 is bromo. In some embodiments, R 3 is bromo. In some
  • R 4 is bromo. In some embodiments, R 5 is bromo. In some embodiments, R 6 is bromo. In some embodiments, R is bromo.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO.
  • R 2 is -CHO.
  • R 3 is -CHO.
  • R 4 is -CHO.
  • R 5 is -CHO.
  • R 6 is -CHO.
  • R is -CHO.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - (CH 2 ) x -COOH.
  • R 2 is -(CH 2 ) x -COOH.
  • R 3 is - (CH 2 ) x -COOH.
  • R 4 is -(CH 2 ) x -COOH.
  • R is - (CH 2 ) x -COOH.
  • R 6 is -(CH 2 ) x -COOH.
  • R is- (CH 2 ) x -COOH.
  • x is one to three. In some embodiments, x is one.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is heteroaryl or substituted heteroaryl. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is benzimidazole or substituted benzimidazole. In some embodiments, one of R 2 and R is benzimidazole or substituted benzimidazole. In some embodiments, the benzimidazole is substituted with C 1-6 alkyl, halogen, -COOH, or -CHO.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5 . In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCOCH 3 . In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -CONH 2 . In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOC 1 _ 6 alkyl.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen, and the rest are hydrogen.
  • the halogen is bromo.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH. In some embodiments, one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) X - COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2, R3, R5 , R6 , and R V' is bromo; one of R 2, R 3, R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - (CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R V is halogen or -OCH 2 3 4 5 R 6 , and R V
  • one of R , R , R , R is - (CH 2 ) x -COOH; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is halogen or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • R 2 and R 3 together with the atoms they attach to, form a substituted six-membered heterocyclyl ring. In some embodiments, R and R , together with the atoms they attach to, form a substituted six-membered heterocyclyl ring containing one nitrogen. In some embodiments, R 2 and R 3 , together with the atoms they
  • R 8 , R 10 , and R 11 are independently selected from hydrogen, halogen, -(CH 2 ) x -C(0)-OCi_ 6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , - OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) y -CO-COOH, -(CH 2 ) y -C(H)(OH)- COOH, phenyl, and substituted phenyl; wherein the substituted phenyl is substituted with 1-4 substituents selected from hydroxyl, Ci-ealkoxy, and Ci-ealkyl; and R 9 is hydrogen or C 1-6 alkyl.
  • R 2 is selected from halogen, -CHO, and - (CH 2 ) x -COOH and R 1 and R3 are hydrogen.
  • R 3 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 1 , R2", and R 4" are hydrogen.
  • R 4 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 3 , R 5 , and R 6 are hydrogen.
  • R 5 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 4 , R 6 , and R 7 are hydrogen.
  • R 6 is selected from halogen, -CHO, and -(CH 2 ) X - COOH and R 4 , R 5 , and R 7 are hydrogen.
  • R 7 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 1 and R 6 are hydrogen.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are hydrogen.
  • R 2 is hydrogen. In some embodiments of Formula (I), R 2 is -CHO. In some embodiments of Formula (I), R 2 is -(CH 2 ) x -COOH. In some embodiments of Formula (I), R is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of
  • R 2 is halogen. In some embodiments of Formula (II), R 2 is bromo. In some embodiments of Formula (I), R 2 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (I), R is -OCH 2 C 6 Hs. In some embodiments of Formula (I),
  • R 2" is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (I), R 2 is heteroaryl or substituted heteroaryl. In some embodiments of Formula (I), R" is -OCOCH 3 or -(CH 2 ) X - 9
  • R is C ⁇ aUcyl, Ci-ealkoxy, amino, or
  • R is -(CH 2 ) x -C(0)-OC 1 _6 alkyl.
  • R 3 is hydrogen. In some embodiments of Formula (I), R 3 is -CHO. In some embodiments of Formula (I), R 3 is -(CH 2 ) x -COOH. In some embodiments of Formula (I), R is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of
  • R 3 is halogen. In some embodiments of Formula (I), R 3 is bromo. In some embodiments of Formula (I), R 3 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (I), R is -OCH 2 C 6 H 5 . In some embodiments of Formula (I),
  • R 3 J is -(CH H or -(CH 2 ) X -CN. In some embodiments of Formula (I), R 3
  • R J is -OCOCH 3 or -(CH 2 ) X - CONH 2 .
  • R is C 1-6 aLkyl, Ci ⁇ alkoxy, amino, or substituted amino.
  • R is -(CH 2 ) x -C(0)-OC 1 _6 alkyl.
  • R 2 and R 3 together with the atoms they attach to, form an unsubstituted five to seven-membered heterocyclyl ring.
  • R and R together with the atoms they attach to, form a substituted five to
  • R and R together with the
  • R and R together with the atoms they attach to, form a seven-membered heterocyclyl ring.
  • R 4 is hydrogen. In some embodiments of Formula (I), R 4 is -CHO. In some embodiments of Formula (I), R 4 is -(CH 2 ) x -COOH. In some embodiments of Formula (I), R 4 is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of Formula (I), R 4 is halogen. In some embodiments of Formula (I), R 4 is bromo. In some embodiments of Formula (I), R 4 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 4 is -OCH 2 C 6 Hs. In some embodiments of Formula (I), R 4 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (I), R 4 is heteroaryl or substituted heteroaryl. In some embodiments of Formula (I), R 4 is -OCOCH 3 or -(CH 2 ) X - CONH 2 . In some embodiments of Formula (I), R 4 is C 1-6 alkyl, Ci-ealkoxy, amino, or substituted amino. In some embodiments of Formula (I), R 4 is -(CH 2 ) x -C(0)-OC 1 _ 6 alkyl.
  • R 5 is hydrogen. In some embodiments of Formula (I), R 5 is -CHO. In some embodiments of Formula (I), R 5 is -(CH 2 ) x -COOH. In some embodiments of Formula (I), R 5 is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of Formula (I), R 5 is halogen. In some embodiments of Formula (I), R 5 is bromo. In some embodiments of Formula (I), R 5 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 5 is -OCH 2 C 6 Hs. In some embodiments of Formula (I), R 5 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (I), R 5 is heteroaryl or substituted heteroaryl. In some embodiments of Formula (I), R 5 is -OCOCH 3 or -(CH 2 ) X - CONH 2 . In some embodiments of Formula (I), R 5 is C 1-6 alkyl, Ci-ealkoxy, amino, or substituted amino. In some embodiments of Formula (I), R 5 is -(CH 2 ) x -C(0)-OC 1 _6 alkyl.
  • R 6 is hydrogen. In some embodiments of Formula (I), R 6 is -CHO. In some embodiments of Formula (I), R 6 is -(CH 2 ) x -COOH. In some embodiments of Formula (I), R 6 is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of Formula (I), R 6 is halogen. In some embodiments of Formula (I), R 6 is bromo. In some embodiments of Formula (I), R 6 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 6 is -OCH 2 C 6 H 5 . In some embodiments of Formula (I), R 6 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (I), R 6 is heteroaryl or substituted heteroaryl. In some embodiments of Formula (I), R 6 is -OCOCH 3 or -(CH 2 ) X - CONH 2 . In some embodiments of Formula (I), R 6 is C 1-6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino. In some embodiments of Formula (I), R 6 is -(CH 2 ) x -C(0)-OCi-6 alkyl.
  • R 7 is hydrogen. In some embodiments of Formula (I), R 7 is -CHO. In some embodiments of Formula (I), R 7 is -(CH 2 ) x -COOH. In some embodiments of Formula (I), R is -(CH 2 ) x -COOC 1-6 alkyl. In some embodiments of
  • R 7 is halogen. In some embodiments of Formula (I), R 7 is bromo. In some embodiments of Formula (I), R 7 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (I), R is -OCH 2 C 6 Hs. In some embodiments of Formula (I),
  • R 7' is -(CH 2 ) x -OH or -(CH 2 ) X -CN.
  • R 7 is heteroaryl or substituted heteroaryl.
  • R' is -OCOCH 3 or -(CH 2 ) X - CONH 2 .
  • R is C 1-6 alkyl, Ci-ealkoxy, amino, or substituted amino.
  • R is -(CH 2 ) x -C(0)-OC 1-6 alkyl.
  • R 6 and R 7 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 6 and R 7 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 5 and R 6 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 5 and R 6 , together with the atoms they attach to, form a five-membered carbocyclic ring. [0191] In some embodiments of Formula (I), R 4 and R 5 , together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 4 and R 5 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • compositions comprising a compound of Formula (II):
  • R 1 is hydrogen, C 1-6 alkyl, or hydroxy
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci ⁇ alkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, -(CH 2 ) x -C(0)-OC 1 _6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X - CN, -OCH 2 C 6 H 5 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COOCi_ 6 alkyl, -(CH 2 ) y -CO-COOH, and - (CH 2 ) y -C(H)(OH)-COOH; or
  • x is a number from zero to six
  • y is a number from zero to six
  • R 1 is hydrogen. In some embodiments, R 1 is C 1-6 alkyl. In some embodiments, R 1 is methyl. In some embodiments, R 1 is hydroxy.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is selected from halogen, -CHO, and -(CH 2 ) x -COOH.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is a halogen.
  • at least one of R , R , R ⁇ , R , R , and R' is bromo.
  • R 2 is bromo.
  • R 3 is bromo.
  • R 4 is bromo. In some embodiments, R 5 is bromo. In some embodiments, R 6 is bromo. In some embodiments, R is bromo.
  • R 7' is -CHO.
  • R 2 is -CHO.
  • R 3 is -CHO.
  • R 4 is -CHO.
  • R 5 is -CHO.
  • R 6 is -CHO.
  • R 7 is -CHO.
  • R 7 is - (CH 2 ) x -COOH.
  • R 2 is -(CH 2 ) x -COOH.
  • R 3 is - (CH 2 )x-COOH.
  • R 4 is -(CH 2 ) x -COOH.
  • R 5 is - (CH 2 ) x -COOH.
  • R 6 is -(CH 2 ) x -COOH.
  • R is- (CH 2 ) x -COOH.
  • x is one to three. In some embodiments, x is one.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) X - COOCi-ealkyl.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen, and the rest are hydrogen.
  • the halogen is bromo.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH. In some embodiments, one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) X - COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R , R , R ⁇ , R , R , and R' is bromo; one of R , R , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - (CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is halogen or -OCH 2 C 6 H 5 .
  • one of R , R , R , R , R , and R is - (CH 2 )x-COOH; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 )x-COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H5; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is halogen or -OCH 2 C 6 H5; and the rest are hydrogen.
  • R 2 is selected from halogen, -CHO, and - (CH 2 ) x -COOH and R 1 and R3 are hydrogen.
  • R 3 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 1 , R2", and 4 are hydrogen.
  • R 4 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 3 , R 5 , and R 6 are hydrogen.
  • R 5 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 4 , R 6 , and R 7 are hydrogen.
  • R 6 is selected from halogen, -CHO, and -(CH 2 ) X - COOH and R 4 , R 5 , and R 7 are hydrogen.
  • R 7 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 1 and R 6 are hydrogen.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are hydrogen.
  • R 2 is hydrogen. In some embodiments of Formula (II), R 2 is -CHO. In some embodiments of Formula (II), R 2 is -(CH 2 ) x -COOH.
  • R is -(CH 2 ) x -COOC 1 _6 alkyl.
  • R 2 is halogen.
  • R 2 is bromo.
  • R 2 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R is -OCH 2 C 6 H 5 .
  • R 2 is -(CH 2 )x-OH or -(CH 2 ) X -CN.
  • R 2 is C ⁇ aUcyl, Ci-ealkoxy, amino, or substituted amino. In some embodiments of Formula (II), R is - (CH 2 )x-C(0)-OCi_6 alkyl.
  • R 3 is hydrogen. In some embodiments of Formula (II), R 3 is -CHO. In some embodiments of Formula (II), R 3 is -(CH 2 ) x -COOH. In some embodiments of Formula (II), R is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of Formula (II), R 3 is halogen. In some embodiments of Formula (II), R 3 is bromo. In some embodiments of Formula (II), R 3 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R is -OCH 2 C 6 Hs.
  • R 3 is -(CH 2 )x-OH or -(CH 2 ) X -CN.
  • R 3 is C h alky!, Ci-ealkoxy, amino, or substituted amino.
  • R is - (CH 2 ) x -C(0)-OC 1 _ 6 alkyl.
  • R 4 is hydrogen. In some embodiments of Formula (II), R 4 is -CHO. In some embodiments of Formula (II), R 4 is -(CH 2 ) x -COOH. In some embodiments of Formula (II), R 4 is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments of Formula (II), R 4 is halogen. In some embodiments of Formula (II), R 4 is bromo. In some embodiments of Formula (II), R 4 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 4 is -OCH 2 C 6 H 5 . In some embodiments of Formula (II), R 4 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (II), R 4 is Ci-ealkyl, Ci-ealkoxy, amino, or substituted amino. In some embodiments of Formula (II), R 4 is - (CH 2 ) x -C(0)-OCi_ 6 alkyl.
  • R 5 is hydrogen. In some embodiments of Formula (II), R 5 is -CHO. In some embodiments of Formula (II), R 5 is -(CH 2 ) x -COOH. In some embodiments of Formula (II), R 5 is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments of Formula (II), R 5 is halogen. In some embodiments of Formula (II), R 5 is bromo. In some embodiments of Formula (II), R 5 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 5 is -OCH 2 C 6 Hs. In some embodiments of Formula (II), R 5 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (II), R 5 is Ci-ealkyl, Ci- 6 alkoxy, amino, or substituted amino. In some embodiments of Formula (II), R 5 is - (CH 2 ) x -C(0)-OCi_ 6 alkyl.
  • R 6 is hydrogen. In some embodiments of Formula (II), R 6 is -CHO. In some embodiments of Formula (II), R 6 is -(CH 2 ) x -COOH. In some embodiments of Formula (II), R 6 is -(CH 2 ) x -COOCi- 6 alkyl. In some embodiments of Formula (II), R 6 is halogen. In some embodiments of Formula (II), R 6 is bromo. In some embodiments of Formula (II), R 6 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 6 is -OCH 2 C 6 Hs. In some embodiments of Formula (II), R 6 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (II), R 6 is Q-ealkyl, Ci- 6 alkoxy, amino, or substituted amino. In some embodiments of Formula (II), R 6 is - (CH 2 ) x -C(0)-OC ! _ 6 alkyl.
  • R 7 is hydrogen. In some embodiments of Formula (II), R 7 is -CHO. In some embodiments of Formula (II), R 7 is -(CH 2 ) x -COOH. In some embodiments of Formula (II), R is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments
  • R is halogen. In some embodiments of Formula (II), R is bromo. In some embodiments of Formula (II), R 7 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In 7
  • R is -OCH 2 C 6 H 5 .
  • R 7 is -(CH 2 )x-OH or -(CH 2 ) X -CN.
  • R 7 is Ci_ 6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino.
  • R is - (CH 2 ) x -C(0)-OCi_ 6 alkyl.
  • R 6 and R 7 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 6 and R 7 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 5 and R 6 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 5 and R 6 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 4 and R 5 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 4 and R 5 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • compositions comprising a compou
  • R 1 is hydrogen, C 1-6 alkyl, or hydroxy
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci-ealkyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, -(CH 2 ) x -C(0)-OCi_6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X - CN, -OCH 2 C 6 H 5 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COOCi-6 alkyl, -(CH 2 ) y -CO-COOH, and - (CH 2 ) y -C(H)(OH)-COOH; or
  • x is a number from zero to six
  • y is a number from zero to six
  • R 1 is hydrogen. In some embodiments, R 1 is Ci_6 alkyl. In some embodiments, R 1 is methyl. In some embodiments, R 1 is hydroxy.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo.
  • R 2 is bromo.
  • R 3 is bromo.
  • R 4 is bromo.
  • R 5 is bromo.
  • R 6 is bromo.
  • R is bromo.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo, and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO, -(CH 2 ) x -COOH, or - OCH 2 C 6 H 5.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH. In some embodiments, one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO, -(CH 2 ) x -COOH, or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is-CHO; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is-OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • R 2 is bromo and R 1 and R 3 are hydrogen.
  • R 3 is bromo and R 1 , R 2 , and R 4 are hydrogen.
  • R 4 is bromo and R 3 , R 5 , and R 6 are hydrogen.
  • R 5 is bromo and R 4 , R 6 , and R 7 are hydrogen.
  • R 6 is bromo and R 4 , R 5 , and R 7 are hydrogen.
  • R 7 is bromo and R 1 and R 6 are hydrogen.
  • R 2 is hydrogen. In some embodiments of Formula (III), R 2 is -CHO. In some embodiments of Formula (III), R 2 is -(CH 2 ) x -COOH.
  • R is -(CH 2 ) x -COOC 1 _6 alkyl.
  • R 2 is halogen.
  • R 2 is bromo.
  • R 2 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R is -OCH 2 C 6 Hs.
  • R 2 is -(CH 2 )x-OH or -(CH 2 ) X -CN.
  • R 2 is Ci_ 6 alkyl, Q-ealkoxy, amino, or substituted amino.
  • R is -(CH 2 ) x -C(0)-OCi_ 6 alkyl.
  • R 3 is hydrogen. In some embodiments of Formula (III), R 3 is -CHO. In some embodiments of Formula (III), R 3 is -(CH 2 ) x -COOH. In some embodiments of Formula (III), R is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of Formula (III), R 3 is halogen. In some embodiments of Formula (III), R 3 is bromo. In some embodiments of Formula (III), R 3 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R is -OCH 2 C 6 Hs.
  • R 3 is -(CH 2 ) x -OH or -(CH 2 ) X -CN.
  • R 3 is Q_ 6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino.
  • R is -(CH 2 ) x -C(0)-OCi_6 alkyl.
  • R 4 is hydrogen. In some embodiments of Formula (III), R 4 is -CHO. In some embodiments of Formula (III), R 4 is -(CH 2 ) x -COOH. In some embodiments of Formula (III), R 4 is -(CH 2 ) x -COOCi-6 alkyl. In some embodiments of Formula (III), R 4 is halogen. In some embodiments of Formula (III), R 4 is bromo. In some embodiments of Formula (III), R 4 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 4 is -OCH 2 C 6 Hs. In some embodiments of Formula (III), R 4 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (III), R 4 is Q- 6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino. In some embodiments of Formula (III), R 4 is -(CH 2 ) x -C(0)-OC ! _ 6 alkyl.
  • R 5 is hydrogen. In some embodiments of Formula (III), R 5 is -CHO. In some embodiments of Formula (III), R 5 is -(CH 2 ) x -COOH. In some embodiments of Formula (III), R 5 is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments of Formula (III), R 5 is halogen. In some embodiments of Formula (III), R 5 is bromo. In some embodiments of Formula (III), R 5 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 5 is -OCH 2 C 6 H 5 . In some embodiments of Formula (III), R 5 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (III), R 5 is Q- 6 alkyl, Q-ealkoxy, amino, or substituted amino. In some embodiments of Formula (III), R 5 is -(CH 2 ) x -C(0)-OC ! _ 6 alkyl.
  • R 6 is hydrogen. In some embodiments of Formula (III), R 6 is -CHO. In some embodiments of Formula (III), R 6 is -(CH 2 ) x -COOH. In some embodiments of Formula (III), R 6 is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments of Formula (III), R 6 is halogen. In some embodiments of Formula (III), R 6 is bromo. In some embodiments of Formula (III), R 6 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 6 is -OCH 2 C 6 Hs. In some embodiments of Formula (III), R 6 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (III), R 6 is Q-
  • R 6 is
  • R 7 is hydrogen. In some embodiments of Formula (III), R 7 is -CHO. In some embodiments of Formula (III), R 7 is -(CH 2 ) x -COOH. In some embodiments of Formula (III), R is -(CH 2 ) x -COOC 1 _6 alkyl. In some embodiments
  • R 7 7 of Formula (III), R is halogen. In some embodiments of Formula (III), R is bromo. In some embodiments of Formula (III), R 7 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (III), R is -OCH 2 C 6 Hs. In some embodiments of Formula (III), R 7 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (III), R 7 is Q. 6 alkyl, Ci-ealkoxy, amino, or substituted amino. In some embodiments of Formula (III), R is -(CH 2 ) x -C(0)-OC ! _ 6 alkyl.
  • R 6 and R 7 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 6 and R , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 5 and R 6 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 5 and R 6 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 4 and R 5 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 4 and R 5 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • compositions comprising a compou
  • R is hydrogen, C 1-6 alkyl, or hydroxy;
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C ⁇ aUcyl, Ci_ 6 alkoxy, amino, substituted amino, halogen, -(CH 2 ) x -C(0)-OC 1 _6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X - CN, -OCH 2 C 6 H 5 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COOC 1-6 alkyl, -(CH 2 ) y -CO-COOH, and - (CH 2 ) y -C(H)(OH)-COOH; or
  • x is a number from zero to six
  • y is a number from zero to six
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is-CHO or -(CH 2 ) x -COOH.
  • R 1 is hydrogen.
  • R 1 is Ci_6 alkyl. In some embodiments, R 1 is methyl. In some embodiments, R 1 is hydroxy.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is selected from - CHO, and -(CH 2 ) x -COOH.
  • R 7' is -CHO.
  • R 2 is -CHO.
  • R 3 is -CHO.
  • R 4 is -CHO.
  • R 5 is -CHO.
  • R 6 is -CHO.
  • R 7 is -CHO.
  • R 7 is -(CH 2 ) x -COOH.
  • R 2 is -(CH 2 ) x -COOH.
  • R 3 is - (CH 2 ) x -COOH.
  • R 4 is -(CH 2 ) x -COOH.
  • R 5 is - (CH 2 ) x -COOH.
  • R 6 is -(CH 2 ) x -COOH.
  • R is - (CH 2 ) x -COOH.
  • x is one to three. In some embodiments, x is one.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5.
  • at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen
  • at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -bromo
  • at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOC 1 _ 6 alkyl.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo or - OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - (CH 2 ) x -COOH and at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H5; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is halogen or -OCH 2 C 6 H5; and the rest are hydrogen.
  • R 2 is selected from -CHO and -
  • R 3 is selected from - CHO and -(CH 2 ) x -COOH and R 1 , R 2 , and R 4 are hydrogen.
  • R is selected from -CHO, and -(CH 2 ) x -COOH and R 3 , R 5 , and R 6 are hydrogen.
  • R 5 is selected from -CHO, and -(CH 2 ) x -COOH and R 4 , R 6 , and R 7 are hydrogen.
  • R 6 is selected from -CHO and -(CH 2 ) x -COOH and R 4 , R 5 , and R 7 are hydrogen.
  • R 7 is selected from -CHO and -(CH 2 ) x -COOH and R 1 and R 6 are hydrogen.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are hydrogen.
  • R 2 is hydrogen. In some embodiments of Formula (IV), R 2 is -CHO. In some embodiments of Formula (IV), R 2 is -(CH 2 ) x -COOH.
  • R" is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments
  • R is halogen. In some embodiments of Formula (IV), R is bromo. In some embodiments of Formula (IV), R 2 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (IV), R is -OCH 2 C 6 H 5 . In some embodiments of Formula (IV), R 2 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (IV), R 2 is Q_ 6 alkyl, Q-ealkoxy, amino, or substituted amino. In some embodiments of Formula (IV), R is -(CH 2 ) x -C(0)-Od_ 6 alkyl.
  • R 3 is hydrogen. In some embodiments of Formula (IV), R 3 is -CHO. In some embodiments of Formula (IV), R 3 is -(CH 2 ) x -COOH.
  • R J is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments
  • R is halogen. In some embodiments of Formula (IV), R is bromo. In some embodiments of Formula (IV), R 3 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (IV), R is -OCH 2 C 6 H 5 . In some embodiments of Formula (IV), R 3 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (IV), R 3 is Ci_ 6 alkyl, Ci-ealkoxy, amino, or substituted amino. In some embodiments of Formula (IV), R is -(CH 2 ) x -C(0)-OCi_6 alkyl.
  • R 4 is hydrogen. In some embodiments of Formula (IV), R 4 is -CHO. In some embodiments of Formula (IV), R 4 is -(CH 2 ) x -COOH. In some embodiments of Formula (IV), R 4 is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments of Formula (IV), R 4 is halogen. In some embodiments of Formula (IV), R 4 is bromo. In some embodiments of Formula (IV), R 4 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 4 is -OCH 2 C 6 Hs. In some embodiments of Formula (IV), R 4 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (IV), R 4 is Q_ 6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino. In some embodiments of Formula (IV), R 4 is -(CH 2 ) x -C(0)-OCi_6 alkyl.
  • R 5 is hydrogen. In some embodiments of Formula (IV), R 5 is -CHO. In some embodiments of Formula (IV), R 5 is -(CH 2 ) x -COOH. In some embodiments of Formula (IV), R 5 is -(CH 2 ) x -COOCi-6 alkyl. In some embodiments of Formula (IV), R 5 is halogen. In some embodiments of Formula (IV), R 5 is bromo. In some embodiments of Formula (IV), R 5 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 5 is -OCH 2 C 6 Hs. In some embodiments of Formula (IV), R 5 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (IV), R 5 is Q- 6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino. In some embodiments of Formula (IV), R 5 is -(CH 2 ) x -C(0)-OC ! _ 6 alkyl.
  • R 6 is hydrogen. In some embodiments of Formula (IV), R 6 is -CHO. In some embodiments of Formula (IV), R 6 is -(CH 2 ) x -COOH. In some embodiments of Formula (IV), R 6 is -(CH 2 ) x -COOCi-6 alkyl. In some embodiments of Formula (IV), R 6 is halogen. In some embodiments of Formula (IV), R 6 is bromo. In some embodiments of Formula (IV), R 6 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH.
  • R 6 is -OCH 2 C 6 H 5 . In some embodiments of Formula (IV), R 6 is -(CH 2 )x-OH or -(CH 2 ) X -CN. In some embodiments of Formula (IV), R 6 is Ci_ 6 alkyl, Ci ⁇ alkoxy, amino, or substituted amino. In some embodiments of Formula (IV), R 6 is -(CH 2 ) x -C(0)-OCi_ 6 alkyl.
  • R 7 is hydrogen. In some embodiments of Formula (IV), R 7 is -CHO. In some embodiments of Formula (IV), R 7 is -(CH 2 ) x -COOH.
  • R' is -(CH 2 ) x -COOC 1 _ 6 alkyl. In some embodiments
  • R 7 7 of Formula (IV), R is halogen. In some embodiments of Formula (IV), R is bromo. In some embodiments of Formula (IV), R 7 is -(CH 2 ) y -CO-COOH or -(CH 2 ) y -C(H)(OH)-COOH. In some embodiments of Formula (IV), R is -OCH 2 C 6 Hs. In some embodiments of Formula (IV), R 7 is -(CH 2 ) x -OH or -(CH 2 ) X -CN. In some embodiments of Formula (IV), R 7 is Q. 6 alkyl, Ci- 6 alkoxy, amino, or substituted amino. In some embodiments of Formula (IV), R is -(CH 2 ) x -C(0)-OC ! _ 6 alkyl.
  • R 6 and R 7 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 6 and R , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 5 and R 6 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 5 and R 6 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • R 4 and R 5 together with the atoms they attach to, form a five to seven-membered carbocyclic ring. In some embodiments, R 4 and R 5 , together with the atoms they attach to, form a five-membered carbocyclic ring.
  • the present disclosure provides a compound of Formula (V) and compositions comprising a compound of Formula
  • R 1 is hydrogen or C 1-6 alkyl
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, Ci-ealkyl, C . 6 alkoxy, -OCH 2 C 6 H 5 , halogen, -CHO, -(CH 2 ) x -COOH; and x is a number from zero to six;
  • R 1 is hydrogen. In some embodiments, R 1 is C 1-6 alkyl. In some embodiments, R 1 is methyl.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen, -CHO or -(CH 2 ) x -COOH. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo, -CHO or -(CH 2 ) x -COOH. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO. In some embodiments, at least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is a halogen.
  • at least one of R , R , R ⁇ , R , R , and R' is bromo.
  • R 2 is bromo.
  • R 3 is bromo.
  • R 4 is bromo. In some embodiments, R 5 is bromo. In some embodiments, R 6 is bromo. In some embodiments, R is bromo.
  • R 7' is -CHO.
  • R 2 is -CHO.
  • R 3 is -CHO.
  • R 4 is -CHO.
  • R 5 is -CHO.
  • R 6 is -CHO.
  • R 7 is -CHO.
  • R is -(CH 2 ) x -COOH. In some embodiments, R is -(CH 2 ) x -COOH. In some embodiments, R 3 is - (CH 2 ) x -COOH. In some embodiments, R 4 is -(CH 2 ) x -COOH. In some embodiments, R 5 is - (CH 2 ) x -COOH. In some embodiments, R 6 is -(CH 2 ) x -COOH. In some embodiments, R is - (CH 2 ) x -COOH. In some embodiments, x is one to three. In some embodiments, x is one.
  • At least one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen, and the rest are hydrogen.
  • the halogen is bromo.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH. In some embodiments, one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) X - COOH.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2, R3, R5 , R6 , and R V' is bromo; one of R 2, R 3, R 4 , R 5 , R 6 , and R 7 is -CHO or -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - (CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is bromo; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -
  • R 2 CHO or -(CH 2 ) x -COOH, and the rest are hydrogen.
  • one of R 2", R 3 J , R 4", R 5 , R 6 , and R 7 is -CHO and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R V is halogen or -OCH 2 3 4 5 6 V
  • one of R , R , R , R , and R is - (CH 2 ) x -COOH; and one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 .
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is - CHO or -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H 5 ; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -CHO; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is halogen or -OCH 2 C 6 H5; and the rest are hydrogen.
  • one of R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 is -(CH 2 ) x -COOH; one of R 2 , R 3 , R 4 , R 5 , R 6 , and R is halogen or -OCH 2 C 6 H5; and the rest are hydrogen.
  • R 2 is selected from halogen, -CHO, and
  • R 3 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 1 , R2", and 4 are hydrogen.
  • R 4 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 3 , R 5 , and R 6 are hydrogen.
  • R 5 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 4 , R 6 , and R 7 are hydrogen.
  • R 6 is selected from halogen, -CHO, and -(CH 2 ) X - COOH and R 4 , R 5 , and R 7 are hydrogen.
  • R 7 is selected from halogen, -CHO, and -(CH 2 ) x -COOH and R 1 and R 6 are hydrogen.
  • R 2 , R 3 , R 4 , R 5 , R 6 , and R 7 are hydrogen.
  • R 2 is hydrogen. In some embodiments of Formula (V), R 2 is -CHO. In some embodiments of Formula (V), R 2 is -(CH 2 ) x -COOH.
  • R is halogen. In some embodiments of Formula (V),
  • R is bromo. In some embodiments of Formula (V), R is -OCH 2 C 6 Hs. In some
  • R is Ci- 6 alkyl or Ci ⁇ alkoxy.
  • R 3 is hydrogen. In some embodiments of Formula (V), R 3 is -CHO. In some embodiments of Formula (V), R 3 is -(CH 2 ) x -COOH. In some embodiments of Formula (V), R is halogen. In some embodiments of Formula (V),
  • R is bromo. In some embodiments of Formula (V), R is -OCH 2 C 6 H 5 . In some
  • R is Ci- 6 alkyl or Ci ⁇ alkoxy.
  • R 4 is hydrogen. In some embodiments of Formula (V), R 4 is -CHO. In some embodiments of Formula (V), R 4 is -(CH 2 ) x -COOH. In some embodiments of Formula (V), R 4 is halogen. In some embodiments of Formula (V), R 4 is bromo. In some embodiments of Formula (V), R 4 is -OCH 2 C 6 H 5 . In some
  • R 4 is C 1-6 alkyl or Ci-ealkoxy.
  • R 5 is hydrogen. In some embodiments of Formula (V), R 5 is -CHO. In some embodiments of Formula (V), R 5 is -(CH 2 ) x -COOH. In some embodiments of Formula (V), R 5 is halogen. In some embodiments of Formula (V), R 5 is bromo. In some embodiments of Formula (V), R 5 is -OCH 2 C 6 Hs. In some
  • R 5 is C 1-6 alkyl or Ci-ealkoxy.
  • R 6 is hydrogen. In some embodiments of Formula (V), R 6 is -CHO. In some embodiments of Formula (V), R 6 is -(CH 2 ) x -COOH. In some embodiments of Formula (V), R 6 is halogen. In some embodiments of Formula (V), R 6 is bromo. In some embodiments of Formula (V), R 6 is -OCH 2 C 6 Hs. In some
  • R 6 is Ci ⁇ alkyl or Ci ⁇ alkoxy.
  • R 7 is hydrogen. In some embodiments of Formula (V), R 7 is -CHO. In some embodiments of Formula (V), R 7 is -(CH 2 ) x -COOH. In some embodiments of Formula (V), R is halogen. In some embodiments of Formula (V),
  • R is bromo. In some embodiments of Formula (V), R is -OCH 2 C 6 H 5 . In some
  • R is C h alky! or Ci ⁇ alkoxy.
  • compositions comprising a compound of Formula (VI):
  • R 1 is hydrogen or C 1-6 alkyl
  • R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen, C 1-6 alkyl, Ci-ealkoxy, amino, substituted amino, halogen, heteroaryl, substituted heteroaryl, -(CH 2 ) x -C(0)-OC 1 _6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH 3 , -(CH 2 ) x -CONH 2 , -CHO, -(CH 2 ) X - COOH, -(CH 2 ) x -COOCi_6 alkyl, -(CH 2 ) y -CO-COOH, and -(CH 2 ) y -C(H)(OH)-COOH;
  • R 8 , R 10 , and R 11 are independently selected from hydrogen, halogen, -(CH 2 ) x -C(0)- OC1-6 alkyl, -(CH 2 ) x -OH, -(CH 2 ) X -CN, -OCH 2 C 6 H 5 , -OCOCH3, -(CH 2 ) x -CONH 2 , -CHO, - (CH 2 ) x -COOH, -(CH 2 ) x -COOCi-6 alkyl, -(CH 2 ) y -CO-COOH, -(CH 2 ) y -C(H)(OH)-COOH, phenyl, and substituted phenyl; wherein the substituted phenyl is substituted with 1-4 substituents selected from hydroxyl, Ci-ealkoxy, and C 1-6 alkyl;
  • R 9 is hydrogen or C 1-6 alkyl
  • x is a number from zero to six
  • y is a number from zero to six
  • R 1 is hydrogen.
  • R 1 is Ci_6 alkyl. In some embodiments, R 1 is methyl.
  • At least one of R 4 , R 5 , R 6 , R 7 , R 8 , R 10 , and R 11 is halogen, -CHO or -(CH 2 ) x -COOH. In some embodiments, at least one of R 4 , R 5 , R 6 , R 7 , R 8 , R 10 , and R 11 is bromo, -CHO or -(CH 2 ) x -COOH. In some embodiments, at least one of R 4 , R 5 , R 6 , R 7 , R 8 , R 10 , and R 11 is bromo.
  • At least one of R 4 , R 5 , R 6 , R 7 , R 8 , R 10 , and R 11 is -CHO. In some embodiments, at least one of R 4 , R 5 , R 6 , R 7 , R 8 , R 10 , and R 11 is -(CH 2 ) x -COOH. In some embodiments, at least one of R 4 , R 5 , R 6 , R 7 , R 8 , R 10 , and R 11 is -(CH 2 ) x -COOC 1 _ 6 alkyl. [0276] In some embodiments of Formula (VI), R 4 , R 5 , R 6 , and R 7 are independently selected from hydrogen and halogen. In some embodiments of Formula (VI), R 4 , R 5 , R 6 , and R are hydrogen.
  • R 8 , R 10 , and R 11 are independently selected from hydrogen, halogen, -(CH 2 ) x -C(0)-OC 1 _ 6 alkyl, -OCH 2 C 6 H 5 , -OCOCH 3 , - (CH 2 ) x -CONH 2 , -CHO, -(CH 2 ) x -COOH, -(CH 2 ) x -COC 1 _ 6 alkyl, phenyl, and substituted phenyl; wherein the substituted phenyl is substituted with 1-4 substituents selected from hydroxyl, Ci ⁇ alkoxy, and C 1-6 alkyl.
  • R 8 , R 10 , and R 11 are independently selected from hydrogen, halogen, -(CH 2 ) x -C(0)-OC 1 _ 6 alkyl, -OCH 2 C 6 H 5 , -OCOCH 3 , - (CH 2 ) x -CONH 2 , -CHO,
  • the present disclosure provides a compound and pharmaceutically acceptable salts thereof and compositions comprising a compound and pharmaceutically acceptable salts thereof for use in the present methods, wherein the compound is selected from the following:
  • the present disclosure provides Compounds 2, 10, 29, 38, 40, 41, 43, and 44 and pharmaceutically acceptable salts thereof for use in the present methods.
  • the indole compound is apoptotic.
  • the indole compound is cytolytic. In some embodiments, the indole compound is pyroptotic. Such properties can be determined, for example, through histology with fresh ex-vivo fat tissues. The presence of cell wall lysis, "ghosting," and loss of integrity of regions of confluent adipocytes can indicate that an indole compound has activity against adipocytes. Signs of apoptosis, histologically, include “ghosting" and regions of shrinking or much smaller cells. Signs of cytolysis include disruption of cell walls, and with aggressive compositions and the detergent controls, large "moth-eaten" regions where no cells exist; they have all been lysed. Signs of pyroptosis include a combination of both findings. In a live animal or human, cytolysis can produce inflammatory changes.
  • the indole compounds are inflammatory. In some embodiments, the indole compounds are non-inflammatory. In some embodiments, the indole compounds are moderately inflammatory. Depending on the mechanism of action, the level of inflammation induced by indole compounds varies. Inflammatory response is generated when the cell wall is mechanically lysed or the cell dies an ischemic death.
  • Apoptosis is noninflammatory. There are no macrophages, nor is there an apoptotic target . Apoptosis occurs when the cell is programmed to die. The cell shrinks and "ghosting— the residual intact cell wall without much cytoplasm— can be seen.
  • the indole compound is at least about 25% (such as at least about any of 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100%) more specific to adipocytes than to muscle cells (such as skeletal muscle cells). In some embodiments, the indole compound is at least about 80% more specific to adipocytes than to muscle cells (such as skeletal muscle cells). In some embodiments, the indole compound is at least about 2x, 3x, or 4x more specific to adipocytes than to muscle cells (such as skeletal muscle cells).
  • the indole compound is at least about 25% (such as at least about any of 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100%) more specific to adipocytes than to nerve cells (such as peripheral nerve cells). In some embodiments, the indole compound is at least about 80% more specific to adipocytes than to nerve cells (such as peripheral nerve cells). In some embodiments, the indole compound is at least about 2x, 3x, or 4x more specific to adipocytes than to nerve cells (such as peripheral nerve cells).
  • the indole compound is at least about 25% (such as at least about any of 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100%) more specific to adipocytes than to dermal cells (such as dermal fibroblasts). In some embodiments, the indole compound is at least about 80% more specific to adipocytes than to dermal cells (such as dermal fibroblasts). In some embodiments, the indole compound is at least about 2x, 3x, or 4x more specific to adipocytes than to dermal cells (such as dermal fibroblasts).
  • the indole compound is selected from the group consisting of Compounds 2 and 43. In some embodiments, the indole compound has a cell killing activity and tissue specificity that are at least as high as those of an indole compound selected from the group consisting of Compounds 2 and 43.
  • the indole compound is selected from the group consisting of Compounds 40 and 41. In some embodiments, the indole compound has a cell killing activity and tissue specificity that are at most as high as those of an indole compound selected from the group consisting of Compounds 40 and 41.
  • the indole compound is selected from the group consisting of Compounds 10 and 29. In some embodiments, the indole compound has a cell killing activity and tissue specificity that are at least as high as those of an indole compound selected from the group consisting of Compounds 27 and 28.
  • the indole compound is a compound having a cell killing activity that is between the cell killing activity of Compounds 2 or 43 and Compounds 10 or 29. In some embodiments, the indole compound is a compound having a cell killing activity that is between the cell killing activity of Compounds 10 or 29 and Compounds 40 and 41. In some embodiments, the indole compound is a compound having a cell killing activity that is between the cell killing activity of Compounds 2 or 43 and Compounds 40 or 41.
  • a method of determining whether an indole compound is suitable for any of the therapeutic methods described herein comprising assessing the activity, tissue specificity, and/or cell killing mechanism (apoptotic, cytolytic, pyroptotic, etc.) of the compound.
  • the compound is selected (or deemed suitable for use) if the compound has high activity against adipocytes and high tissue specificity.
  • the compound is selected (or deemed suitable for use) if the compound has high activity against adipocytes and moderate tissue specificity. In some embodiments, the compound is selected (or deemed suitable for use) if the compound has moderate activity against adipocytes and high tissue specificity. In some embodiments, the compound is selected (or deemed suitable for use) if the compound is apoptotic. In some embodiments, the compound is selected (or deemed suitable for use if the compound is cytolytic. In some embodiments, the compound is selected (or deemed suitable for use) if the compound is pyroptotic.
  • compositions can be formulated as a pharmaceutically acceptable salt of a disclosed compound.
  • Pharmaceutically acceptable salts are non-toxic salts of a free base form of a compound that possesses the desired
  • salts may be derived from inorganic or organic acids.
  • Non-limiting examples of pharmaceutically acceptable salts include sulfates, pyrosulfates, bisulfates, sulfites, bisulfites, phosphates, monohydrogen-phosphates, dihydrogenphosphates, metaphosphates, pyrophosphates, chlorides, bromides, iodides, acetates, propionates, decanoates, caprylates, acrylates, formates, isobutyrates, caproates, heptanoates, propiolates, oxalates, malonates, succinates, suberates, sebacates, fumarates, maleates, butyne-l,4-dioates, hexyne-l,6-dioates, benzoates, chlorobenzoates,
  • compositions can be formulated for various types of delivery e.g., topical, subcutaneous, subdermal, intralesional, or hypodermal, etc. by any means known in the art.
  • Such formulations can be in the form of a tablet, powder, gel, solution, cream, vapor, ointment, etc.
  • an indole compound is formulated into a solution.
  • such solution is aqueous.
  • aqueous refers to a solution which is a homogenous mixture prepared by dissolving a solid or a liquid in water such that the molecules of the solute or dissolved substance are dispersed among those of water.
  • Pharmacologically acceptable aqueous vehicles for the compositions of the present invention can include, for example, any liquid solution that is capable of dissolving an indole compound and is not toxic to the particular individual receiving the formulation.
  • examples of pharmaceutically acceptable aqueous vehicles include, without limitation, saline, water and acetic acid.
  • pharmaceutically acceptable aqueous vehicles are sterile.
  • the indole compound is in an aqueous solution buffered at a pH of between about 8.0 and about 8.5.
  • compositions are formulated for veterinary applications with one or more veterinary excipients.
  • compositions are formulated for cosmetic applications with one or more cosmetic excipients.
  • the compositions are formulated with one or more pharmaceutical excipients.
  • a "pharmaceutically acceptable excipient” or “pharmaceutical excipient” may be used herein, and refers to a compound that is useful in preparing a pharmaceutical composition that is generally safe, non-toxic and neither biologically nor otherwise undesirable, and includes excipients that are acceptable for veterinary use or human pharmaceutical use.
  • a pharmaceutically acceptable excipient as used herein includes both one and more than one such excipient.
  • excipients include lactose, dextrose, sucrose, sorbitol, mannitol, starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, phosphatidylcholine, cellulose, sterile water, syrup, and methyl cellulose.
  • the formulations can additionally include: lubricating agents such as talc, magnesium stearate, and mineral oil; wetting agents; emulsifying and suspending agents; and preserving agents such as methyl - and propylhydroxy-benzoates and benzyl alcohol.
  • suitable excipients include cyclodextrins (such as hydroxypropyl-cyclodextrin and sulfobutylether-cyclodextrin), polyethylene glycol, polyethylene glycol-400 (PEG-400), Tween 80, ethanol, and DMSO.
  • cyclodextrins such as hydroxypropyl-cyclodextrin and sulfobutylether-cyclodextrin
  • polyethylene glycol polyethylene glycol-400 (PEG-400)
  • Tween 80 ethanol
  • DMSO DMSO
  • Additional excipients suitable for formulation with an indole compound include penetration enhancers and dispersion agents.
  • dispersion agents which allow the dispersion of drugs in tissue include hyaluronidase and collagenase.
  • Hyaluronidase functions to augment tissue permeability and spread or dispersion of other drugs.
  • Collagenase has been used to isolate adipocytes from subcutaneous fat and does not have lytic effects on adipocytes themselves. Additionally hyaluronidase and collagenase can facilitate healing by accelerating reduction of necrotic tissue after treatment with the indole compound formulations of the present invention.
  • a formulation comprising an indole compound is administered by injection, for example, by bolus injection.
  • the formulation can have direct contact with the fat tissue.
  • the formulation can be injected subcutaneously or infused directly into the fat.
  • the formulation can have direct contact with the skin tissue for skin and soft tissue tightening.
  • the formulation can be injected or infused directly into the skin tissue.
  • Formulations for injection can be presented in unit dosage form, for example, in ampoules or in multi-dose containers, with or without an added preservative.
  • the compositions can take such forms as suspensions, solutions, or emulsions in oily or aqueous vehicles, and can contain formulatory agents such as suspending, stabilizing and/or dispersing agents.
  • a unit dose comprises an amount of a compound of an indole compound.
  • the indole compound is a compound of Formula (I).
  • a unit dose has an amount of an indole compound in a volume of solution.
  • a unit dose comprises of more than 0.1% w/w, w/v or v/v of an indole compound and the unit dose has a total volume of more than 0.2 ml and less than 500 ml. In some embodiments, a unit dose comprises of more than 0.1% w/w, w/v or v/v of an indole compound and the unit dose has a total volume of more than 0.1 ml and less that 0.2 ml. In some embodiments, a unit dose comprises of more than 0.1% w/w, w/v or v/v of an indole compound and the unit dose has a total volume of less than 0.1 ml.
  • a solution for injection comprises about 1-20 mg/ml of an indole compound. In some embodiments, a solution for injection comprises about 1-5, 6-10, 11-15, or 16-20 mg/ml of an indole compound. In some embodiments, a solution for injection comprises about 8-12 or 10 mg/ml of an indole compound.
  • unit doses are in a container or a syringe.
  • Such unit doses can have, for example, a total volume of up to 100, 90, 80, 70, 60, 50, 40, 30, 20, 10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.09, 0.08, 0.07, 0.06, 0.05, 0.04, 0.03, 0.02, 0.01, 0.009, 0.008, 0.007, 0.006, 0.005, 0.004, 0.003, 0.002, 0.001, 0.0009, 0.0008, 0.0007, 0.0006, 0.0005, 0.0004, 0.0003, 0.0002, or 0.0001 ml.
  • a total volume of up to 100, 90, 80, 70, 60, 50, 40, 30, 20, 10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.09, 0.08, 0.07, 0.06,
  • a unit dose has a total volume in the range of 0.0001-100, 0.0005-90, 0.001-80, 0.005-70, 0.01-60, 0.05-50, 0.06-40, 0.07-30, 0.08-20, 0.09-10, or 0.1-5 ml.
  • Other embodiments contemplate a unit dose with a total volume in the range of 0.01-2, 0.05-1 or 0.1-0.5 ml total volume.
  • a unit dose has a total volume greater 0.0001, 0.0002, 0.0005, 0.001, 0.002, 0.005, 0.01, 0.02, 0.05, 0.1, 0.2, 0.5, 1, 2, 5, 10, 20, 50, 100 ml.
  • a unit dose has a total volume of up to 1.0, 0.9. 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.05, or 0.01 ml.
  • a unit dose includes up to 10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.09, 0.08, 0.07, 0.06, 0.05, 0.04, 0.03, 0.02, 0.01, 0.009, 0.008, 0.007, 0.006, 0.005, 0.004, 0.003, 0.002, 0.001, 0.0009, 0.0008, 0.0007, 0.0006, 0.0005, 0.0004, 0.0003, 0.0002, or 0.0001 grams of an indole compound.
  • a unit dose includes a range of approximately 0.00001 to 20, 0.00005 to 15, 0.0001 to 12.5, 0.0005 to 10, 0.001 to 7.5, or 0.005 to 5 grams. In some embodiments, a unit dose comprises about 0.01, 0.1, 1, or 2 grams of an indole compound.
  • compositions that can be co-formulated, coadministered, and/or co-marketed with a second therapeutic agent.
  • the second therapeutic agent is co-formulated with an indole compound and administered simultaneously with the indole compound.
  • the second therapeutic agent is administered prior to or after the administration of an indole compound.
  • the second therapeutic agent can be administered locally, regionally, or systemically.
  • the second therapeutic agent is a detergent, a bile acid, bile salt, deoxycholic acid or a salt thereof.
  • the second therapeutic agent is phosphatidylcholine or deoxycholate or mixtures thereof.
  • Non-limiting examples of second therapeutic agents include: anesthetics, antimicrobial agents, vasoconstrictors, anti-thrombotic agents, anti-coagulation agents, antiinflammatory agents, analgesics, dispersion agents, anti-dispersion agents, penetration enhancers, steroids, tranquilizers, muscle relaxants, anti-diarrhea agents, beta adrenergic stimulators, and collagenase.
  • the compositions can further comprise an amount of beta adrenergic stimulator.
  • a beta adrenergic stimulator can bind either directly or indirectly to the beta-receptor, thereby stimulating it.
  • the stimulated receptor triggers a complex series of events involving multiple enzyme systems which results in an accumulation of cyclic AMP within the cell and decreased ATP. These conditions can activate lipases which break down triglyceride fats in the adipocytes into free fatty acids, which can be used by the cell for growth and metabolism, or may be discharged extracellularly.
  • beta adrenergic stimulators individually or in combination can be included in the compositions, such as isoproterenol hydrochloride (ISUPREL®), isoproterenol hydrochloride, forskolin, norepinephrine, guarana and clenbuterol, or other beta-receptor specific agonist (or nonspecific agonists such as ephedrine as to certain applications)
  • compositions can further comprise, individually or in various permutations or combinations, an amount of collagenase, such as Clostridial collagenase or an amount of one or more of nicotinic acid, clofibrate, tannic acid, scorpion toxin, snake venom, beta adrenic stimulants, dimethlyaminoethanol, hyaluronic acid, penta- O-galloyl-alpha-D-glucose, hormone sensitive lipase, human adipose triglyceride lipase, TNF-alpha, raspberry ketone, ethanol, rosiglitazone, peroxisome-proliferator activated receptor gamma, Y-9738 (ethyl 2(4-chlorophenyl)-5-ethoxy-4-oxazoleacetate) oliphen, fish oil, scallop shell extract, peanut shell extract, caffeine, or bee venom.
  • collagenase such as Clos
  • Anti-microbial agents suitable for use with the compositions, methods, and kits herein include, but not limited to, anti-bactericidal agents, anti-fungal agents, anti-viral agents or the like, and are efficacious against a broad spectrum of microbes.
  • anti-bacterial agents include, but not limited to, benzalkonium chloride, benzoic acid, benzoxonium chloride, benzyl alcohol, 2-bromo-2-nitropropane-l,3- diol, 5-bromo-5-nitro-l,3-dioxane, bromochlorophene, camphor benzalkonium methosulfate, captan, cetrimonium bromide, cetrimonium chloride, cetylpyridinium chloride, climbazol, chloracetamide, chlorhexidine and its salts, p-chloro-m-cresol, chlorphenesin, chloroxylenol, chlorophen, chlorobutanol, o-cymen-5-ol, dehydroacetic acid, dibromodicyanobutan, dibromohexamidin, dibromopropamidin, dichlorobenzyl alcohol, dichlorophenyl
  • undecylenic acid useful as anti-microbial agents are e.g.
  • esters such as methyl ester, isopropyl ester, glyceryl ester, ethoxylated soya sterol ester, or ethoxylated PHB ester, or amides, such as monoethanolamide, monoethanolamide derivatives such as monoethanolamide (MEA) sulfo succinate salts, diethanolamide, protein condensates, e.g. potassium undecylenoyl hydrolyzed animal collagen, and quaternized 3-aminopropyl-amide, e.g. undecylenamidopropyltrimonium methosulfate.
  • amides such as monoethanolamide, monoethanolamide derivatives such as monoethanolamide (MEA) sulfo succinate salts, diethanolamide, protein condensates, e.g. potassium undecylenoyl hydrolyzed animal collagen, and quaternized 3-aminopropyl-amide, e.g. undecylenamidoprop
  • fungicidal/fungistatic agents include, without limitation, dithiocarbamates, phthalimides, dicarboximides, organophosphates, benzimidazoles, carboxanilides, phenylamides, phosphites, and the like.
  • anti-bacterial agents include, but are not limited to, erythromycin, clarithromycin, penicillins, cephalosporins, aminoglycosides, sulfonamides, macrolides, tetracyclins, lincosides, quinolones, chloramphenicol, vancomycin,
  • metronidazole metronidazole, rifampin, isoniazid, spectinomycin, trimethoprim, sulfamethoxazole, penems, carbapenems, monobactams mupirocin, neomycin sulfate bacitracin, polymyxin B, 1- ofloxacin, tetracyclines (chlortetracycline hydrochloride, oxytetracycline hydrochloride and tetrachcycline hydrochoride), clindamycin phsphate, gentamicin sulfate, benzalkonium chloride, benzethonium chloride, hexylresorcinol, methylbenzethonium chloride, phenol, quaternary ammonium compounds, triclocarbon, triclosan, tea tree oil, and their
  • anti-bacterial agents include, but are not limited to, Acrof oxacin, Amoxicillin plus clavulonic acid (i.e. Augmentin), Amikacin, Amplicillin, Apalcillin, Apramycin, Astromicin, Arbekacin, Aspoxicillin, Azidozillin, Azithromycin, Aziocillin, Bacitracin, Benzathine penicillin, Benzylpenicillin, Carbencillin, Cefaclor, Cefadroxil, Cefalexin, Cefamandole, Cefaparin, Cefatrizine, Cefazolin, Cefbuperazone, Cefcapene, Cefdinir, Cefditoren, Cefepime, Cefetamet, Cefixime, Cefinetazole, Cefminox, Cefoperazone, Ceforamide, Cefotaxime, Cefotetan, Cefo
  • Phenethicillin, Phenoxymethyl penicillin, Pipemidic acid, Piperacillin, Piperacillin and Tazobactam combination Piromidic acid, Procaine penicillin, Propicillin, Pyrimethamine, Rifabutin, Rifamide, Rifampicin, Rifamycin SV, Rifapentene, Rokitamycin, Rolitetracycline, Roxithromycin, Rufloxacin, Sitafloxacin, Sparfloxacin, Spectinomycin, Spiramycin, Sulfadiazine, Sulfadoxine, Sulfamethoxazole, Sisomicin, Streptomycin, Sulfamethoxazole, Sulfisoxazole, Synercid (Quinupristan-Dalfopristan combination), Teicoplanin,
  • Vasoconstrictor agents suitable for use with the compositions of the present invention can include, for example, dihydroergotamine, ergotamine and methysergide, epinephrine, norepinephrine, and pharmaceutically- acceptable salts thereof.
  • Anti-thrombotic agents suitable for use with the compositions of the present invention can include, for example, argatroban, iloprost, lamifiban, taprostene, tirofiban, tissue plasminogen activator (natural or recombinant), tenecteplase (TNK), and lanoteplase (nPA); factor Vila inhibitors; factor Xa inhibitors; thrombin inhibitors (such as hirudin and argatroban); PAI-1 inhibitors (i.e., inactivators of tissue plasminogen activator inhibitors); alpha2-antiplasmin inhibitors; streptokinase, urokinase and prourokinase; and anisoylated plasminogen streptokinase activator complex, anti-coagulants (e.g.
  • hirudin heparin, etc.
  • plasminogen activators e.g. t-PA, urokinase, etc.
  • fibrinolytic enzymes e.g. plasmin, subtilisin, etc.
  • anti-platelet-aggregation agents e.g. prostacyclin, aspirin, etc.
  • Anti-coagulation agents suitable for use with the compositions of the present invention can include, for example, cilostazol (PLETAL®, Otsuka), clopidogrel (PLAVIX®, Sanofi), ticlopidine (TICLID®, Syntex), tirofiban (AGGRASTAT®, Merck), eptifibatide (INTEGRILIN®, COR Therapeutics), abciximab (REOPRO®, Eli Lilly), anagrelide
  • anti-dispersion agents include, but are not limited to, sucrose, glyercerol, and glycerin.
  • Steroids suitable for use with the compositions of the present invention can include, for example, betamethasone, chloroprednisone, clocortolone, cortisone, desonide, dexamethasone, desoximetasone, difluprednate, estradiol, fludrocortisone, flumethasone, flunisolide, fluocortolone, fluprednisolone, hydrocortisone, meprednisone,
  • methylprednisolone paramethasone, prednisolone, prednisone, pregnan-3-alpha-ol-20-one, testosterone, and triamcinolone, estradiol, estron, estriol, polyestradiol, polyestriol, dienestrol, diethylstilbestrol, dihydroergosterone, cyproterone, danazol, testosterone, progesterone, norethindrone, levonorgestrol, ethynodiol, norgestimate, gestanin, 3 keton-desogestrel, demegestone, promethoestrol, testosterone, spironolactone, and esters thereof, budesonide, rofleponide, rofleponide palmitate, ciclesonide, momethasone furoate, fluticasone propionate, tipredane, fhiocinolone acetonide, fhinisolide,
  • Anti-inflammatory agents suitable for use with the compositions of the present invention can include both steroidal anti-inflammatory agents and non-steroidal antiinflammatory agents.
  • Suitable steroidal anti-inflammatory agent can include, although are not limited to, corticosteroids such as hydrocortisone, hydroxyltriamcinolone alphamethyl dexamethasone, dexamethasone-phosphate, beclomethasone dipropionate, clobetasol valerate, desonide, desoxymethasone, desoxycorticosterone acetate, dexamethasone, dichlorisone, diflorasone diacetate, diflucortolone valerate, fluadrenolone, fluclarolone acetonide, fludrocortisone, flumethasone pivalate, fluosinolone acetonide, fluocinonide, flucortine butylester, fluocortolone, fluprednidene (fluprednylidene
  • hydrocortamate meprednisone, paramethasone, prednisolone, prednisone, beclomethasone dipropionate, betamethasone dipropionate, triamcinolone, and mixtures thereof can be used.
  • compositions of the present invention includes the nonsteroidal anti-inflammatory agents.
  • Suitable non-steroidal anti-inflammatory agents useful in the compositions of the present invention include, but are not limited to: the oxicams, such as piroxicam, isoxicam, tonexicam, sudoxicam, and CP- 14,304; the salicylates, such as salicylic acid, aspirin, disalcid, benorylate, trilisate, safapryn, solprin, diflunisal, and fendosal; the acetic acid derivatives, such as diclofenac, fenclofenac, indomethacin, sulindac, tolmetin, isoxepac, furofenac, tiopinac, zidometacin, acematacin, fentiazac, zomepiract, clidanac, oxepinac, and fel
  • Analgesics suitable for use with the composition of the present invention to reduce discomfort due to inflammation after subcutaneous injection of the formulation of the present invention include, but are not limited to, injectable local amine and ester anesthetics.
  • injectable local amine and ester anesthetics include, but are not limited to, injectable local amine and ester anesthetics.
  • analgesics include ropivacaine, lidocaine, mepivacaine,
  • analgesics include opioids.
  • opioids include morphine, or a salt thereof, such as the sulphate, chloride, or hydrochloride.
  • 1,4- hydroxymorphinan opioid analgesics that may be used herein include those such as naloxone, meperidine, butorphanol or pentazocine, or morphine-6-glucuronide, codeine,
  • dihydrocodeine diamorphine, dextropropoxyphene, pethidine, fentanyl, alfentanil, alphaprodine, buprenorphine, dextromoramide, diphenoxylate, dipipanone, heroin
  • the analgesic is hydromorphone, oxycodone, or morphine, e.g. morphine sulphate and fentanyl and/or pharmaceutically- acceptable salts thereof.
  • Suitable tranquilizer and sedative drugs that may included in the kits or compositions of the present invention include chlordiazepoxide, benactyzine, benzquinamide, flurazepam, hydroxyzine, loxapine, promazine, and/or acceptable salts and esters thereof.
  • Suitable muscle relaxant drugs that may be included in the kits or
  • compositions of the present invention include cinnamedrine, cyclobenzaprine, flavoxate, orphenadrine, papaverine, mebeverine, idaverine, ritodrine, dephenoxylate, dantrolene, azumolene, and/or pharmaceutically-acceptable salts thereof.
  • Suitable anti-diarrhea drugs may be included in the kits or compositions of the present invention include, for example, loperamide, and/or pharmaceutically- acceptable salts thereof.
  • Second therapeutic agents may be co-formulated and/or co-administered with an indole compound.
  • a second therapeutic agent may be at a concentration of less than 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.4%, 0.3%, 0.2%, 0.1%, 0.09%, 0.08%, 0.07%, 0.06%, 0.05%, 0.04%, 0.03%, 0.02%, 0.01%, 0.009%, 0.008%, 0.007%, 0.006%, 0.005%, 0.004%, 0.003%, 0.002%, 0.001%, 0.0009%, 0.0008%, 0.0007%, 0.0006%, 0.0005%, 0.0004%, 0.0003%, 0.0002%, or 0.0001% w/w, w/v or v/v.
  • a second therapeutic agent may be co-formulated with an indole compound.
  • the second therapeutic agent may be at a concentration greater than 20%, 19.75%, 19.50%, 19.25% 19%, 18.75%, 18.50%, 18.25% 18%, 17.75%, 17.50%, 17.25% 17%, 16.75%, 16.50%, 16.25% 16%, 15.75%, 15.50%, 15.25% 15%, 14.75%, 14.50%, 14.25% 14%, 13.75%, 13.50%, 13.25% 13%, 12.75%, 12.50%, 12.25% 12%, 11.75%, 11.50%, 11.25% 11%, 10.75%, 10.50%, 10.25% 10%, 9.75%, 9.50%, 9.25% 9%, 8.75%, 8.50%, 8.25% 8%, 7.75%, 7.50%, 7.25% 7%, 6.75%, 6.50%, 6.25% 6%, 5.75%, 5.50%, 5.25% 5%
  • a second therapeutic agent may be co-formulated with an indole compound such that the final formulation has a concentration of the second therapeutic agent that is in the range of from approximately 0.001% to approximately 50%, approximately 0.001% to approximately 40%, approximately 0.01% to approximately 30%, approximately 0.02% to approximately 29%, approximately 0.03% to approximately 28%, approximately 0.04% to approximately 27%, approximately 0.05% to approximately 26%, approximately 0.06% to approximately 25%, approximately 0.07% to approximately 24%, approximately 0.08% to approximately 23%, approximately 0.09% to approximately 22%, approximately 0.1% to approximately 21%, approximately 0.2% to approximately 20%, approximately 0.3% to approximately 19%, approximately 0.4% to approximately 18%, approximately 0.5% to approximately 17%, approximately 0.6% to approximately 16%, approximately 0.7% to approximately 15%, approximately 0.8% to approximately 14%, approximately 0.9% to approximately 12%, approximately 1% to approximately 10% w/w, w/v or v/v. It is understood that the final concentration is dependent on many factors known to persons skilled in the art including, but
  • a composition herein comprises less than 10 g, 9.5 g, 9.0 g, 8.5 g, 8.0 g, 7.5 g, 7.0 g, 6.5 g, 6.0 g, 5.5 g, 5.0 g, 4.5 g, 4.0 g, 3.5 g, 3.0 g, 2.5 g, 2.0 g, 1.5 g, 1.0 g, 0.95 g, 0.9 g, 0.85 g, 0.8 g, 0.75 g, 0.7 g, 0.65 g, 0.6 g, 0.55 g, 0.5 g, 0.45 g, 0.4 g, 0.35 g, 0.3 g, 0.25 g, 0.2 g, 0.15 g, 0.1 g, 0.09 g, 0.08 g, 0.07 g, 0.06 g, 0.05 g, 0.04 g, 0.03 g, 0.02 g, 0.01 g, 0.009 g, 0.008 g,
  • a composition herein comprises more than 0.0001 g, 0.0002 g, 0.0003 g, 0.0004 g, 0.0005 g, 0.0006 g, 0.0007 g, 0.0008 g, 0.0009 g, 0.001 g, 0.0015 g, 0.002 g, 0.0025 g, 0.003 g, 0.0035 g, 0.004 g, 0.0045 g, 0.005 g, 0.0055 g, 0.006 g, 0.0065 g, 0.007 g, 0.0075 g, 0.008 g, 0.0085 g, 0.009 g, 0.0095 g, 0.01 g, 0.015 g, 0.02 g, 0.025 g, 0.03 g, 0.035 g, 0.04 g, 0.045 g, 0.05 g, 0.055 g, 0.06 g, 0.065 g, 0.07 g, 0.075 g
  • a composition herein comprises 0.0001-10 g, 0.0005-9 g, 0.001-8 g, 0.005-7 g, 0.01-6 g, 0.05-5 g, 0.1-4 g, 0.5-4 g, or 1-3 g of the one or more second therapeutic agents herein.
  • the present disclosure provides a kit for the reduction or removal of localized fat deposits and/or skin and soft tissue tightening in the subject.
  • the kit can provide a nonsurgical method of reduction or removal of localized fat deposits and/or skin and
  • the kit includes one or more containers.
  • a container comprises any of the compositions herein.
  • a container can comprise an indole compound.
  • a syringe can comprise an indole compound.
  • the indole compound is a compound of Formula (I).
  • an indole compound may be prepared in a solution or in an injectable solution.
  • a container comprising such a solution may have sufficient volume to hold one or more unit doses.
  • a container may be adapted to hold a less than 500 ml, 100 ml solution, 20 ml solution 10 ml solution or 5 ml solution.
  • a container can hold a volume of about 0.01 ml to about 100 ml, about 0.1 ml to about 90 ml, about 0.5 ml to about 80 ml, about 1 ml to about 70 ml, about 2 ml to about 60 ml, about 3 ml to about 50 ml, about 4 ml to about 40 ml, about 5 ml to about 30 ml, about 6 ml to about 20 ml, and about 7 ml to about 10 ml.
  • a container is an ampule having a volume capacity of about 10 to about 20 ml.
  • an indole compound is formulated in a transdermal patch or a subdermal depot for sustained release. Dosages in a patch or depot can be the same as those discussed herein.
  • the container can optionally include one or more second therapeutic agents.
  • a container includes an analgesic, antimicrobial agent, or antiinflammatory agent.
  • the kit may further include a second container comprising a second active agent.
  • a second therapeutic agent in a second container include, for example, an antimicrobial agent, an anti-thrombotic agent, an anti-coagulation agent, an antiinflammatory agent, an analgesic, an anesthetic, an anti-dispersion agent, a dispersion agent, a penetration enhancer, a steroid, a tranquilizer, a muscle relaxant, and an anti-diarrhea agent.
  • Instructions for use can provide dosing instructions which may depend upon, for example, location of target site, animal being treated, desired results, size of target site, concentration of the indole compound in composition, etc.
  • instructions for use are for the treatment of an animal such as a human, a dog, a cat, or a horse. Instructions for use can also include information for treatment of other domesticated animals and/or farm animals.
  • Instruction for use may also include information on the use of the compositions herein to treat specific target sites, such as, e.g., fat deposits or areas of loose skin localized under eye, under chin, under arm, buttock, cheek, brow, calf, back, thigh, ankle, or stomach.
  • specific target sites such as, e.g., fat deposits or areas of loose skin localized under eye, under chin, under arm, buttock, cheek, brow, calf, back, thigh, ankle, or stomach.
  • instruction for use detail an explanation for use of the compositions herein to treat a fat condition of obesity, fat redistribution syndrome, dorsocervical fat, visceral adiposity, breast enlargement, breast ptosis, localized lipodystrophy with or without associated pendulosity, hyperadiposity, eyelid fat herniation, lipomas, lipodystrophy, buffalo hump lipodystrophy, diffused body fat around trunk and arms, or fat deposits associated with cellulite.
  • instructions for use detail an explanation for use of the compositions herein to prevent or reduce a skin condition associated with aging, such as lax skin, and subcutaneous tissue, a localized pendulous overhang of skin and subcutaneous tissue, irregularities of the skin, and wrinkles.
  • Instruction for use may include information regarding proper diluents and volumes for dilution, if any, of the container.
  • the instructions for use may also provide information regarding the proper administration of the compositions herein, such as frequency and dosage of administration.
  • the kit may further comprise a syringe or other suitable delivery device (e.g., transdermal pump, transdermal patch, or subdermal depot) for delivering the compositions in the container to a localized fat deposit or loose skin.
  • a syringe or delivery device may be preloaded with a unit dose of a solution of the present invention.
  • a syringe or delivery device may be preloaded with a fat-dissolving or skin-tightening effective amount of an indole compound.
  • Test compounds are commercially available. Test compounds include compounds from Table 1. Comparative non-indole compounds were also tested: C-8, C-19, C-20, C21, C-56, C-57, C-58, C-60, and C-61. Positive controls include 1% sodium deoxycholate (DC) (MasterPharm, Richmond Hill, NY), phosphatidylcholine 25 mg/ml plus deoxycholate 12 mg/ ml (MasterPharm, Richmond Hill, NY), PC 50/ DC24 (Network Lipolysis, Drensteinfurt, Germany) and Aqualyx ®, a sodium deoxycholate in a lactose carrier. Compound 44H is a high concentration version of Compound 44.
  • DC sodium deoxycholate
  • PC 50/ DC24 Network Lipolysis, Drensteinfurt, Germany
  • Aqualyx ® a sodium deoxycholate in a lactose carrier.
  • Compound 44H is a high concentration version of Compound 44.
  • Test compounds were tested in immediate ex-vivo tissue. Test compounds include a negative control (saline) which shows no response, or normal adipocyte
  • DMSO plus PBS negative controls
  • positive controls include 1% sodium deoxycholate (MasterPharm, Richmond Hill, NY), phosphatidylcholine 25 mg/ml plus deoxycholate 12 mg/ ml (MasterPharm, Richmond Hill, NY), PC 50/ DC24 (Network Lipolysis, Drensteinfurt, Germany) and Aqualy
  • cytotoxicity assays including Presto Blue® (Invitrogen, Grand Island, NY), Alamar Blue® (Invitrogen, Grand Island, NY), Cyto-Tox One® (Promega, Madison, WI), and Cell Titer Glo® (Promega, Madison, WI). Due to reaction of several test compounds with the blue dye, the redox assays were discontinued. An MTT terazolium assay was performed, as well as LDH and ATP based assays. It was determined that the most consistency occurred with the dual function assays, Multi-Tox Fluor® (Promega, Madison, WI) and LIVE/DEAD® for mammalian cells (Invitrogen, Grand Island, NY). The LIVE/DEAD® for mammalian cells assay was used. LIVE/DEAD® for mammalian cells assay is a calcein (live read)/ ethidium bromide (dead) multiplex assay.
  • the most strongly tissue preferential group included six tested compounds, Compounds 2 and 43 in the aggressive category, Compounds 40 and 41 in the moderate range, and Compounds 29 in the less aggressive range. (Compound 10 is not shown in Figure 5.) These compounds had adipocyte cytotoxicity numbers that are 3 to 4 times stronger than those noted with other tissue types. Additional data for tissue specificity results are shown in the table below.
  • the PC/DC compositions were indiscriminate.
  • Aqualyx® had slight tissue specificity toward nerve tissue and endothelial tissue.
  • the deoxycholate composition was indiscriminate.
  • Figure 6 shows results for test compounds for adipocytes, dermis, and muscle cells for Compound B (saline control) and Compounds 1, 2, 3, 4, 5, and 10. All the bars in Figure 6 indicate kill rate (ethidium).
  • kill rate ethidium
  • “a” refers to compound tissue preference at 2 hours.
  • “b” refers to compound tissue preference at 5 hours.
  • Compounds 2 and 10 were the most aggressive in this group of compounds. Compound 4 was less aggressive, but shows specificity for adipocyte killing. Compound 1 showed no preference for cells over time. Compound 5 showed more nerve preservation, but a late dermal spike appeared.
  • Figure 7 shows results for test compounds for adipocytes, dermis, and muscle cells for Compound C (saline control), Compounds D and E (deoxycholate), and Compounds 29, 7, 33, 38, and 40. All the bars in Figure 7 indicate kill rate (ethidium).
  • kill rate ethidium
  • “a” refers to compound tissue preference at 2 hours.
  • “b” refers to compound tissue preference at 5 hours.
  • Compound C is a saline control
  • Compound D is a saline control
  • Compounds D and E are detergents that showed no tissue specificity. Recent reports following clinical trials of 1% deoxycholate show two instances of facial nerve palsy and numbness with paresthesias in up to 40% of patients treated. Compounds D and E are toxic to nerve and dermal fibroblasts as they are to adipocytes.
  • Compound 29 is strongly adipocyte preferential, while the adipocyte kill rate is equivalent to that of Compounds D and E.
  • Compound 7 showed not tissue preference.
  • Compound 33 showed definite tissue specificity at two time points. While the specificity is not as strong as other compounds tested, there is much more tissue specificity than with Compounds D and E.
  • Compound 38 was an aggressive adipocyte killer and is also toxic to nerve cells, although not nearly as toxic to dermal fibroblasts.
  • Compound 40 showed tissue specificity at two time points. In Figure 7, Compounds 29 and 40 showed the most specificity for adipocyte killing among the compounds tested in this group.
  • Compound 33 showed moderate tissue specificity, but a fairly low adipocyte kill rate.
  • Figure 8 shows results for test compounds for adipocytes, dermis, and muscle cells for Compound F (saline control), Compounds G (Aqualyx ®), and Compounds 41, 43, and 44. All the bars in Figure 8 indicate kill rate (ethidium).
  • kill rate ethidium
  • “a” refers to compound tissue preference at 2 hours.
  • “b” refers to compound tissue preference at 5 hours.
  • Compound F is a saline control; Compound G is Aqualyx ®. Compound G showed no tissue specificity.
  • Compounds H and I are diluent controls, which include cells and DMSO/PBS.
  • CellDMpb is a diluent having DMSO and PBS and cells.
  • Compound 41 had a high tissue preference index and strong adipocytolytic capability. Compound 41 is not as aggressive as Compounds 2, 38, or 43. Compound 43 is adipolytic, yet has a low kill rate for nerve cells and dermis. It is a more aggressive than Compound 41. Compound 41 would be effective in areas where there is a large fat deposit. Compound 44 is not as specific as the other compounds tested in this group.
  • the following table shows tissue specificity results for the tested compounds.
  • a sample of DMSO/PBS was a negative control.
  • a sample of Aqualyx® was a positive control.
  • 24M is phosphatidylcholine 25 mg/ml plus deoxycholate 12 mg/ and 25N is C 50/ DC24; these were positive controls.
  • the numbers in the table refer to averaged ethidium numbers.
  • the percentages represent the relative kill rate for each cell type when rated against the adipocyte kill rate for that compound. All tissue types were tested on the same plate against adipocytes in order to standardize results.
  • Compounds 28, 91 and 94 showed high kill rate for adipocytes and high specificity for adipocytes over nerve cells, dermal cells, muscle cells, and endothelial cells.
  • Compounds 78, 2, 27, and 40 showed high specificity for adipocytes over nerve cells, dermal cells, muscle cells, and endothelial cells.
  • Compounds 5, 4, 30, 33, and 44 showed about 50% preferential for adipocytes over nerve cells, dermal cells, muscle cells, and endothelial cells.
  • Compounds 3 and 38 showed moderate preference of adipocytes over nerve cells, dermal cells, muscle cells, and endothelial cells.
  • the compounds of the embodiments appear to have a pyroptotic mechanism of action. Pyroptosis is a relatively new category of cell death mechanism.
  • apoptosis is programmed cell death and by definition, there is no inflammation, cytolysis causes cell membrane rupture followed by an immediate onset of swelling and inflammation in the affected area.
  • Pyroptosis is defined as a combination of these two mechanisms, in which some cells die as a programmed function, and some cells die due to mitochondrial dysfunction or cell wall lysis or both. Pyroptosis is the central continuum between apoptosis and cell wall lysis, with some clinical and microscopic manifestations of both.
  • Figure 9A shows a saline control with adipocytes intact.
  • Figure 9B shows a histology test sample with 1% deoxycholate at 4 hours.
  • Cell wall lysis with a large area of "missing" tissue is present.
  • the central oblique line of injection shows significant cell damage while normal fat can be seen at the periphery, in the lower left and upper right corners. This is a classic appearance, showing the limited dispersion of the deoxycholate compound.
  • Figure 9C shows a histology test sample with PC50/ DC 24 at 12 hours.
  • Figure 9D shows a histology test sample with Compound 88 at 4 hours. The appearance is very similar to that of PC/DC. Pyknotic nuceli are present. Both ghosting and quite shrunken cells are noted with folding of the cytoplasmic membrane. This is an example of a compound with similar efficacy as PC/DC, with a primarily apoptotic mechanism of action.
  • Figure 9E shows a histology test sample with Compound 41 at twelve hours. Pyroptotic mechanism is well demonstrated here. Two areas of cytolysis are shown using dark arrows. Pyknotic nuclei are strongly present, as are ghosting and shrunken intact cells.
  • Figure 9F shows a histology test sample with Compound 38 at four hours.
  • the mechanism of action of this compound is primarily cytolysis, as seen by fragmentation of multiple cell walls, and empty area where adipocytes used to be. Some signs of apoptosis are present. In some embodiments, it is difficult to assign an exclusively cytolytic or apoptotic mechanism, as both are most commonly seen.
  • Figure 9G shows a histology test sample with Compound 2 at 1 hour. This compound is aggressive, and cases more cytolysis than apoptosis.
  • Figure 9H shows a histology test sample with Compound 29 at 12 hours. This compound exhibits primarily an apoptotic mechanism.
  • Figure 91 shows a histology test sample with Compound 33 at 4 hours.
  • Indole the parent compound, shows pyroptotic activity when injected into adipose tissue.
  • a tattoo marking the injection site is seen in the upper left margin.
  • Dark arrows show regions of cytolysis. ghosting of apoptotic cells is also visible.
  • the compounds of the embodiments have a variety of effects on adipocytes, with some compounds inducing more programmed cell death, and some more aggressive compounds primarily working by lysing cell membranes the majority of compounds are pyroptotic; evidence of both mechanisms of cell death is seen.
  • FIG. 10 shows an injection pattern for basic level users of an injectable lipolytic composition. This pattern presupposes some dispersion of the injectable composition. In the facial region, a grid or ruler was used to measure the distance between injection points.
  • deoxycholate injections standard of practice. Aesthetic Plast. Surg. 2008; 32: 858-72, these points were described as being 1 cm apart for facial regions, and 1.5 cm apart in body regions. Facial injections should be performed with a meso needle that is 6 mm long, in order to standardize the depth of injection.
  • a dose of 0.2 to 0.4 cc of a 10 mg/ml product is the standard dose per pre-marked injection site in facial regions. In body regions, a dose of 0.4 to 0.5 cc of the same concentration would be used, and the grid pattern would show injection points 1.5 cm apart.
  • An alternative pattern would be a multi-level injection, using an under-the- skin type delivery. These would be performed from a single entry site, and would be executed in a ray-type distribution, similar to liposuction. The value of treating multiple levels of adiposity has been recently shown, so a better and more uniform response can be obtained with this method. Also, drugs with poor dispersion can be better delivered to the target tissue this way.
  • This example reports exemplary compounds reported in Example 1. Over seventy compounds of the embodiments were tested for adipocytolysis, then for tissue preference. A consistent assay with multiplex information was a calcein/ethidium bromide assay that assesses cell viability and cell death simultaneously. Cell viability was checked using the Countess device. All plates were inoculated with 100 microliters of the appropriate cell types. A 6 well repeat was used to verify results. Cell types used included cultured human adult derived adipocytes, dermal fibroblasts, skeletal muscle cells, and endothelial cells (Cell Applications, Inc., San Diego, CA). Human peripheral nerve cells (Innoprot, Spain) were also used.
  • Figure 11 shows results for adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells for control compounds. Normal saline was a negative control.
  • Excipient was DMSO/PBS excipient.
  • Positive controls included phosphatidylcholine 25 mg/ml plus deoxycholate 12 mg/ ml (PC/DC, MasterPharm, Richmond Hill, NY), and Aqualyx ®, a sodium deoxycholate in a lactose carrier (Marllor International, Italy). All the bars in Figure 11 indicate kill rate (ethidium).
  • the tissue preference assays in Figure 11 were repeated three times, one month apart, to verify consistent findings. As shown in Figure 11, the control compounds were indiscriminate for adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells.
  • Figure 12 shows results for adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells for control compounds and test compounds. All the bars in Figure 12 indicate kill rate (ethidium). As shown in Figure 12, Compounds A, B, C, D, and E showed high specificity for adipocytes over dermal cells, nerve cells, muscle cells, and endothelial cells. PC/DC shows uniform cell death with all tissue types. The parent indole compound (Compound 33) showed about 50% tissue preference.
  • Figure 13 shows results for adipocytes, dermal cells, nerve cells, muscle cells, and endothelial cells for control compounds and test compounds. All the bars in Figure 13 indicate kill rate (ethidium). As shown in Figure 13, Compounds F, G, H, I, and J showed high specificity for adipocytes over dermal cells, nerve cells, muscle cells, and endothelial cells. There was no tissue preference for either control (saline and Aqualyx®).
  • This example reports exemplary compounds reported in Example 1.
  • a mouse study was performed to test compounds of the embodiments. Eight test compounds were injected.
  • positive controls included 1% sodium deoxycholate (DC, MasterPharm, Richmond Hill, NY), phosphatidylcholine 25 mg/ml plus deoxycholate 12 mg/ ml (PC/DC, PC25/DC12, MasterPharm, Richmond Hill, NY), and Aqualyx ®, a sodium deoxycholate in a lactose carrier (Marllor International, Italy).
  • mice Seventy nude mice were chosen for a study of safety and efficacy of injectable lipolytic compounds. Human fat was harvested one hour prior to the injection procedure. 0.5 cc of fat was loaded into micro syringes. Engraftment took place under general anesthesia. Four weeks later, the fat pad size was measured and compounds injected precisely using a 6 mm meso needle in the center and 0.5 cm cephalad and caudad to the midpoint. Mice were sacrificed at one day, one week, two weeks and 4 weeks. One mouse died following injection. This same mouse exhibited SRP (sick rodent posture) following engraftment. Three mice developed SRP and were euthanized according to protocol.
  • Each fat pad was measured and weighed on the analytical balance at the time of sacrifice. Photos were taken and histology was performed. SEM was performed at two weeks and 4 weeks. Gross characteristics of the fat were documented.
  • Compound dose was calculated based on the average weight of each mouse and was based on the maximum safe dose of PC/DC. At 0.4 mg/ gram, maximum dose was estimated to be lOmg. Actual dose was 6 mg per mouse.
  • mice were given a special antibiotic diet. No mouse became infected. After the first 24 hours, all recovered well and seemed to ignore the fat pads. Sacrifice of mice took place as schedule. A limited postmortem at 24 hours showed no apparent systemic effects.
  • Figure 14 shows a sample mouse at one day postinjection. No effect from the compound was noted. Neovascularization of the graft was visible beneath the thin skin of this mouse. No effect on adjacent tissue nor vital organs was noted.
  • Figure 15 shows a mouse, injected with Compound B, which had a lobulated graft. The most cephalad pad was not injected. The central pad was injected with 0.1 cc or 1 mg of compound. The most caudal fat pad was injected with 0.2 cc or 2 mg of compound. As early as one week, fat necrosis had been induced with Compound B. Figure 15 shows that fat necrosis occurred prevalently on the most caudal pad and to a lesser degree on the central pad.
  • Figure 16 shows deoxycholate injected fat pad at Day 1. Immediate necrosis was apparent in the injected segment. The lack of dispersion was made clear in this specimen.
  • Figure 17 shows gross appearance of Compound D (above) as compared to excipient control (below), at one week postinjection. Tested compounds of the embodiments appeared to induce some type of fat reaction. Visible gross changes included discoloration as early as one week. Some liquefaction was seen at two weeks. A soft granular appearance with size reduction was noted at 4 weeks.
  • Figure 18 shows a mouse at one week postinjection. The mouse was treated with Compound H. There was discoloration and textural changes in the fat pad after injection of Compound H, as shown in Figure 18.
  • Figure 19 shows the effect of Compound I at two weeks. There is some liquefaction and textural change. Definite fat necrosis was present.
  • Figure 20 shows the effect of Compound I at four weeks. Dispersion was good; the entire fat pad was been affected. A measured 33% reduction in fat pad size was noted. Compound I showed good results and is an excellent test compound in this study.
  • Figure 21 shows PC/DC treated fat pad at 4 weeks. There was almost no visible change from its original condition.
  • Scanning electron microscopy can provide images of a sample's topography and composition. SEM was performed on various adipose cells.
  • Figure 22 shows the appearance of normal fat cells with saline control. There was a very thin, fibrous "netting" that holds the cells together. As shown in Figure 23, the fibrous scar response generated by deoxycholate was massive. There are very few live cells left in this tissue segment; most was fibrous scar response. An ideal response would be either an apoptotic response with little inflammation in cases where only fat reduction is needed, or a combination of fat reduction and moderate inflammation when tissue tightening is the desired response. The compounds of the embodiments can generate these desired responses.
  • Figure 24 shows SEM of an untreated cultured adipocyte.
  • the physical characteristics of adipose cells were easily identified when cultured cells are treated. Intact adipocytes were round, with a mean diameter of about 100 microns. There was great variability in the size of adipocytes, which can range from 30 microns to over 200 microns. The surface of the cell membrane was not slick and smooth.
  • Figure 25 shows intact adipocytes in vivo. These were not perfectly round. Their shape was affected by its neighbors.
  • Figure 26 shows SEM of cultured adipocytes treated with PC/DC at four hours. There was blebbing, a hallmark of apoptosis.
  • Bleb is an irregular bulge in the plasma membrane of a cell.
  • Cell wall injuries can have two outcomes. If a large enough defect is created, the cell cannot repair itself and it undergoes necrosis, with the creation of lysozymes and egress of the cell contents. Clinically, this will result in swelling and inflammation of the treatment region. Smaller blebs may cause poration, which can induce programmed cell death.
  • Figure 27 shows cultured adipocytes treated with PC/DC in vivo at 4 weeks. Blebbing was a prominent feature. Inflammation was denoted by the formation of a fibrous coating of the cells.
  • Figure 28 shows the effect of deoxycholate on a single cultured adipocyte after four hour incubation. The cell membrane has been disrupted at multiple sites.
  • Figure 29 shows a barren landscape of tissue treated with deoxycholate at 4 weeks. There were very few living adipocytes. Fibrous ingrowth was extensive. These SEM findings correlated with the histology seen in deoxycholate treated tissue. The inflammatory reaction was intense; all cells within millimeters of the treatment region died an acute necrotic death. This led to extensive scarring such that the "soft" tissue is no longer soft.
  • Majno's description of the process of adipocyte cell death is either apoptosis or necrosis.
  • Figures 30-31 shows diagrams of a mechanism of action of Majno.
  • PC/DC Phosphatidylcholine/deoxycholate
  • the compounds of embodiments can be shown to follow a different mechanism of action.
  • the mechanism of action includes poration and effusion.
  • the mechanism of action of lipolytic indole compounds is a new one called chemoporation. SEM micrographs of the mechanism are shown in Figures 37-41. A compound of the
  • Figures 32-36 below show examples of a mechanism of action with SEM of poration and effusion.
  • Figures 37-41 below show examples of a mechanism of action with SEM of poration and effusion in close-up views.
  • Figure 32 shows the effect of Compound A on adipocytes in vivo at 4 weeks posttreatment.
  • the cells underwent a process of lipolysis in which thousands of lipid droplets coalesce just under the cell membrane. Poration occurred, and the lipid droplets escaped. When cell volume depletion becomes critical, the cell signals its own death.
  • Figure 33 shows poration of a cultured adipocyte caused by Compound B.
  • FIG 34 shows the effect of Compound B at 4 weeks. There were platelets on cell at the lower right. Compound B elicited a vascular response, with platelets and white blood cells (WBCs) within the treatment region. There was also a lack of extensive scarring.
  • WBCs white blood cells
  • Figure 35 shows severe spongiform poration of an isolated cultured adipocyte after a 4 hour exposure to Compound C. This type of pyroptotic cell death caused less inflammation than deoxycholate's necrotic process.
  • Figure 36 show a negative control with the effect of DMSO excipient at 4 weeks. There were cells that appear intact with slight fibrous adhesions.
  • Figures 37-41 show examples of a mechanism of action with an SEM of poration and effusion in close-up views.
  • Figure 37 shows SEM with a close- up view of poration of an adipocyte.
  • Figure 38 shows a collection of lipid droplets underneath the cell membrane.
  • Figure 39 shows an SEM with a close-up view of effusion of an adipocyte. This was a single cell. There were lipid droplets coming out of the pores.
  • Figure 40 shows a close-up view of a cell treated with Compound J at four weeks. There was extrusion of thousands of lipid droplets.
  • Figure 41 shows a close-up view of adipocyte death.
  • Figures 42-45 show comparison of the effect of Compound J with control compounds.
  • Figure 42 shows tissue injected with saline at four weeks. Cell sizes vary. The fibroseptal network is apparent.
  • Figure 43 shows SEM of tissue treated with PC/DC at four weeks. There is a blebbing mild fibrous reaction. The cells are still intact.
  • Figure 44 shows tissue treated with deoxycholate at four weeks. Massive fibrous replacement of normal tissue is apparent.
  • Figure 45 shows tissue treated with Compound J at four weeks. There are lipid droplets and a single lysed cell. Fibrous response with Compound J is modest.
  • Figures 46-50 show the effects of tested compounds.
  • Figure 46 shows the effect of Compound D at 4 weeks following injection into human fat. This effect was similar to, but more profound than the effect of PC/DC. There was collapse of cell volume with round exteriorized lipid droplets. There were also lumpy shapes just under the cell membrane. These were hundreds of lipid droplets waiting to escape.
  • Figure 47 shows the effect of Compound E in vivo after 4 weeks. There are extracellular lipid droplets, and folding of a dying adipocyte. A disrupted cell is noted in the lower right of the figure. Some fibrous response is noted.
  • Figure 48 shows tissue treated with Compound I at 4 weeks. There were lipid droplets that have discharged through the cell wall. This mechanism was characteristic of the compounds of the embodiments.
  • Figure 49 shows the effect of Compound H at four weeks. There were crumpled cells, exteriorized lipid droplets, and more fibrous response than other tested compounds.
  • Figure 50 shows the effect on cultured cells that were treated with Compound I for four hours. Compound I induced an array of response including some cell lysis.

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Abstract

La présente invention concerne des composés d'indole et des compositions et utilisations de ceux-ci, comprenant l'utilisation des composés d'indole et des compositions pour la réduction ou l'élimination de dépôts de graisse localisés et/ou le resserrement du relâchement de la peau et des tissus mous chez des sujets. Les composés d'indole peuvent être utilisés, par exemple, dans le secteur cosmétique ou pour fabriquer des produits pharmaceutiques.
PCT/US2013/048368 2013-03-13 2013-06-27 Utilisation de composés d'indole pour la réduction des graisses et le resserrement de la peau et des tissus mous WO2014143125A1 (fr)

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US15/807,081 US10258605B2 (en) 2013-03-13 2017-11-08 Use of indole compounds for fat reduction and skin and soft tissue tightening
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US10258605B2 (en) 2013-03-13 2019-04-16 Alevere Medical Corporation Use of indole compounds for fat reduction and skin and soft tissue tightening
US10653670B2 (en) 2013-03-13 2020-05-19 Alevere Medical Corporation Use of indole compounds for fat reduction and skin and soft tissue tightening
US10058553B2 (en) 2013-10-21 2018-08-28 Alevere Medical Corporation Fused heterotricyclic organic coumpounds, pharmaceutical compositions, and medical uses thereof
US10888563B2 (en) 2013-10-21 2021-01-12 Alevere Medical Corporation Fused heterotricyclic organic compounds, pharmaceutical compositions, and medical uses thereof
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